Ricardo M. Fontanet Grana, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9201 Issued in PR

Practice address

Go7 Ave Campo Rico
Country Club
Carolina, PR 00982-2678

Phone

(787) 633-8152

Fax

(787) 762-9110

NPI assigned

Aug 18, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in PR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Centro Pediatrico Country Club

  • Medical Specialty Clinic/Center
  • Carolina, PR
  • NPI 1841320082
  NPD (past)
• Medicina Primaria Avanzada PSC

  • General Practice Physician
  • Carolina, PR
  • NPI 1467382739

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1104818954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GO7 AVE CAMPO RICO",
            "address_2": "COUNTRY CLUB",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009822678",
            "telephone_number": "787-633-8152",
            "fax_number": "787-762-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GO7 AVE CAMPO RICO",
            "address_2": "COUNTRY CLUB",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009822678",
            "telephone_number": "787-633-8152",
            "fax_number": "787-762-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANET GRANA",
        "first_name": "RICARDO",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "9201",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "9201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL",
            "identifier": "061680",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS INSURANCE",
            "identifier": "81706",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALIC",
            "identifier": "P-1319",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GLOBAL",
            "identifier": "129660590181",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "9820006",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Milagros Florian German, MD
• FMG Care Management Coordinator Inc.
• Liza V Fonseca
• Aracelis Font, M.D.
• Miguel A Fontan
• Pablo Andres Fontanet Sanchez, MD
• Hector O Fontanet, MD
• Daniel Josue Fontanez-Irizarry
• Andres Fortuna
• FPC Expreso, Inc

• Pediatrics Physician in Carolina, PR
• Providers in Carolina, PR by specialty
• Pediatrics Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.