Individual provider Active NPI

John Fontana, MD

  • Obstetrics & Gynecology Physician
  • Beaufort, SC
National Provider Identifier
1043228752
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
075723 Issued in SC
Practice address
989 Ribaut Rd Ste 210
Beaufort, SC 29902-5481
Phone
(843) 524-8151
Fax
(843) 524-1954
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 075723 SC Primary

Addresses

Primary practice location

989 Ribaut Rd Ste 210
Beaufort, SC 29902-5481

Mailing address

106 Capers St
Beaufort, SC 29902-5202
Phone (843) 524-8151

Other identifiers 1

IdentifierTypeStateIssuer
075723/PA0726MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110830000201 SC Practitioner - Obstetrics/Gynecology 1951442201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.95 of 100Reported as group
Quality
83.15
Promoting interoperability
100
Improvement activities
40
Cost
73.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
075723SCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort County Memorial Hospital Obstetrics & Gynecology CurrentSince Jan 1, 2018 Accepting new patients
Beaufort County Memorial Hospital CurrentSince Jan 1, 2018 Accepting new patients
Gynecology Associates of Beaufort PC Obstetrics & Gynecology PastSince May 26, 2015 Accepting new patients
The Surgery Center of Beaufort LLC PastSince Jul 12, 2000 Accepting new patients

Locations

989 Ribaut Rd
Ste 103
Beaufort, SC 29902
Phone (843) 522-5351

955 Ribaut Rd
#C
Beaufort, SC 29902

989 Ribaut Rd
Ste 210
Beaufort, SC 29902
Phone (843) 522-7820

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

1835 N Paris Ave
#108
Port Royal, SC 29935
Phone (843) 812-0483

1000 Pine St W
Varnville, SC 29944
Phone (803) 943-5228

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1043228752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 CAPERS ST",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025202",
            "telephone_number": "843-524-8151",
            "fax_number": "843-524-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 RIBAUT RD STE 210",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025481",
            "telephone_number": "843-524-8151",
            "fax_number": "843-524-1954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANA",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "075723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075723/PA0726",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

Verify at the official NPI Registry.