Alfredo Fanelli

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN12492 Issued in FL

Practice address

1770 N Wickham Rd
Melbourne, FL 32935-8122

Phone

(321) 235-0606

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Castle 1St Dental Care PA

  • General Practice Dentistry
  • Melbourne, FL
  • NPI 1700958956
  NPD (past)
• Valley Forge Dental of FL PA

  • General Practice Dentistry
  • Melbourne, FL
  • NPI 1912079187
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043370919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358122",
            "telephone_number": "321-235-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358122",
            "telephone_number": "321-235-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANELLI",
        "first_name": "ALFREDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN12492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Familiar Medical Services
• Family First Physicians LLC
• Family Home Alf, LLC
• Family Pillars Homecare, LLC
• Family Pratice of Suntree and Viera, P.a.
• Sonia Fantauzzi
• Tony Faris
• Danielle Farls
• Heather Lynn-Z Farmer
• Rehan Ahmad Farooqui, MD

• All providers in Melbourne, FL
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.