Individual provider Active NPI

Emilio Fentanes, M.D.

  • Cardiovascular Disease Physician
  • Fort Sam Houston, TX
National Provider Identifier
1093009276
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD17066 Issued in HI
Practice address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone
(210) 539-8414
NPI assigned
Jun 5, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD17066 HI Primary
Diagnostic Radiology Physician 2085R0202X 315357 NY

Addresses

Primary practice location

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Mailing address

PO Box 932163
Cleveland, OH 44193-0008
Phone (610) 477-6147

Other practice location 1

1100 Wilford Hall Loop Bldg 4554
Jbsa Lackland, TX 78236-5638
Phone (210) 916-9335

Other practice location 2

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NY, FL, MO, KS5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20230414000573 UT Practitioner - Diagnostic Radiology 7012270911 Reassigns benefits to 1 organization
I20240206000631 NY Practitioner - Cardiovascular Disease (Cardiology) 7012270911 Reassigns benefits to 2 organizations
I20250205002635 FL Practitioner - Diagnostic Radiology 7012270911 Reassigns benefits to 1 organization
I20250328001995 MO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7012270911 Reassigns benefits to 2 organizations
I20250423000219 KS Practitioner - Cardiovascular Disease (Cardiology) 7012270911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians
Midwest Heart and Vascular Specialists LLCGroup PAC ID 7618122417, 81 clinicians
Radiology Associates of Northern Kentucky PLLCGroup PAC ID 3779480736, 56 clinicians

Practice addresses (Care Compare)

1500 Route 112
Port Jefferson Station, NY 11776-8054
Phone (631) 751-3000

17065 S Outer Rd
Belton Regional Medical Center
Belton, MO 64012-2165
Phone (816) 348-1200

19600 E 39TH St S
Centerpoint Medical Center
Independence, MO 64057-2301
Phone (816) 698-7000

2000 SE Blue Pkwy
Suite 250
Lees Summit, MO 64063-1029
Phone (913) 906-0833

2100 SE Blue Pkwy
Lees Summit Medical Center
Lees Summit, MO 64063-1007
Phone (816) 282-5000

2316 E Meyer Blvd
Research Medical Center
Kansas City, MO 64132-1136
Phone (913) 253-3000

2800 E Rock Haven Rd
Cass Regional Medical Center
Harrisonville, MO 64701-4411
Phone (816) 380-3474

2820 E Rock Haven Rd
Harrisonville, MO 64701-4414

285 Sills Rd
East Patchogue, NY 11772-4808
Phone (631) 751-3000

365 E Main St
Patchogue, NY 11772-3145
Phone (631) 751-3000

48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000

5721 W 119TH St
Menorah Medical Center
Overland Park, KS 66209-3722
Phone (913) 498-6000

7300 Lees Summit Rd
Kansas City, MO 64136-1248
Phone (859) 301-2160

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD17066HIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Health Care Corporation CurrentSince Jun 9, 2025 Accepting new patients
North Shore Hematology Oncology Associates PC CurrentSince Feb 1, 2024 Accepting new patients
University of Utah Adult Services Diagnostic Radiology CurrentSince Mar 1, 2023 Accepting new patients
Nassau Health Care Corporation CurrentSince Jun 9, 2025 Accepting new patients
Proscan NCH Imaging LLC Diagnostic Radiology CurrentSince Jan 31, 2025 Accepting new patients
Radiology Associates of Northern Kentucky, PLLC Diagnostic Radiology CurrentSince Dec 1, 2005 Accepting new patients
University of Utah Adult Services CurrentSince Mar 1, 2023 Accepting new patients
Midwest Heart & Vascular Specialists, LLC Cardiovascular Disease CurrentSince May 15, 2025 Accepting new patients
Proscan NCH Imaging LLC Diagnostic Radiology CurrentSince Jan 31, 2025 Accepting new patients
University of Utah Adult Services General Practice Current Accepting new patients
Nassau Health Care Corporation Current Accepting new patients
St Elizabeth Medical Center, Inc Past Accepting new patients
Lester S Duplechan MD PLLC Past Accepting new patients

Locations (25 of 44)

1020 Crosspointe Dr
Ste 103
Naples, FL 34110
Phone (239) 624-4443

600 Wilson Creek Rd
Lawrenceburg, IN 47025
Phone (812) 532-2700

1640 Flossie Dr
Lawrenceburg, IN 47025
Phone (812) 496-3285

12200 W 106th St
Ste 315
Overland Park, KS 66215
Phone (913) 348-4202

5721 W 119th St
Shawnee Msn, KS 66209
Phone (913) 253-3000

7200 Alexandria Pike
Alexandria, KY 41001
Phone (859) 344-5652

309 11th St
Carrollton, KY 41008
Phone (502) 732-3241

329 Floyd Dr
Carrollton, KY 41008
Phone (502) 732-1082

1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353

375 Thomas More Pkwy
Ste 209
Crestview Hills, KY 41017
Phone (859) 341-4842

651 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 341-6660

500 Thomas More Pkwy
Ste 2
Crestview Hls, KY 41017
Phone (859) 341-4842

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

830 Thomas More Pkwy
Ste 101
Edgewood, KY 41017
Phone (859) 301-5600

560 S Loop Rd
Ste 100
Edgewood, KY 41017

413 S Loop Rd
Edgewood, KY 41017
Phone (859) 301-3800

600 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-6382

4123 Olympic Blvd
Ste 150
Erlanger, KY 41018
Phone (859) 301-2999

10095 Investment Way
Florence, KY 41042
Phone (859) 301-9070

4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200

7830 Connector Dr
Florence, KY 41042
Phone (859) 525-2994

8460 US Highway 42
Florence, KY 41042
Phone (859) 282-0911

85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100

2200 Conner Rd
Hebron, KY 41048
Phone (859) 344-5652

2626 Alexandria Pike
Highland Heights, KY 41076
Phone (859) 757-0434

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: emilio.fentanes@hca2.eclinicaldirectplus.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1307232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1093009276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932163",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930008",
            "telephone_number": "610-477-6147",
            "fax_number": "302-440-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-539-8414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Wilford Hall Loop Bldg 4554",
            "address_purpose": "LOCATION",
            "city": "Jbsa Lackland",
            "state": "TX",
            "postal_code": "782365638",
            "country_code": "US",
            "telephone_number": "210-916-9335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 MEDICAL VILLAGE DR",
            "address_purpose": "LOCATION",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "country_code": "US",
            "telephone_number": "859-301-2160",
            "fax_number": "859-341-4845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENTANES",
        "first_name": "EMILIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-05",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "HI",
            "license": "MD17066",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "315357",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.