Active NPI
Arthur C Fenn, MD
- Plastic Surgery within the Head & Neck (Otolaryngology) Physician
- Greenbrae, CA
National Provider Identifier
1043378409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery within the Head & Neck (Otolaryngology) Physician
- License
- G13883
- Practice address
- 1000 S Eliseo Dr
#103
Greenbrae, CA 94904-2133 - Phone
- (415) 461-9770
- Fax
- (415) 461-6744
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 207YX0007X | G13883 | CA | Primary |
| Surgery Physician | 208600000X | G13883 | CA |
Addresses
Primary practice location
1000 S Eliseo Dr
#103
Greenbrae, CA 94904-2133
Mailing address
1000 S Eliseo Dr
#103
Greenbrae, CA 94904-2133
Phone (415) 461-9770
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0040017876 | Other | CA | RAILROAD MCR |
| 00G138830 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audiology Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Audiologist-Hearing Aid Fitter
- Greenbrae, CA
- NPI 1013133578
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267401600000",
"number": "1043378409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 S ELISEO DR",
"address_2": "#103",
"city": "GREENBRAE",
"state": "CA",
"postal_code": "949042133",
"telephone_number": "415-461-9770",
"fax_number": "415-461-6744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 S ELISEO DR",
"address_2": "#103",
"city": "GREENBRAE",
"state": "CA",
"postal_code": "949042133",
"telephone_number": "415-461-9770",
"fax_number": "415-461-6744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENN",
"first_name": "ARTHUR",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2010-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0007X",
"taxonomy_group": "",
"desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
"state": "CA",
"license": "G13883",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "G13883",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MCR",
"identifier": "0040017876",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G138830",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenbrae, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.