Individual provider Active NPI

Angelo Fonte Jr., MD

  • General Practice Physician
  • Nokomis, FL
National Provider Identifier
1104820067
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME78804 Issued in FL
Practice address
115 Tamiami TRL N Ste 7
Nokomis, FL 34275-2162
Phone
(941) 586-7780
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME78804 FL
General Practice Physician 208D00000X ME78804 FL Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X ME78804 FL
Internal Medicine Physician 207R00000X ME78804 FL
Interventional Pain Medicine Physician 208VP0014X ME78804 FL

Addresses

Primary practice location

115 Tamiami TRL N Ste 7
Nokomis, FL 34275-2162

Mailing address

PO Box 1965
Nokomis, FL 34274-1965
Phone (941) 586-7780

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180112002517 FL Order and Referring Only - AnesthesiologyPractitioner - Anesthesiology 4981506896

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME78804FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael W. Kemplin, MD, PA Past Accepting new patients
Center for Spine Pain Inc Interventional Pain Medicine PastSince Apr 3, 2003 Accepting new patients
Gulfcoast Pain Physicians PA Interventional Pain Medicine PastSince Oct 2, 2000 Accepting new patients

Organizations & group practices 3

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1104820067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1965",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342741965",
            "telephone_number": "941-586-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 TAMIAMI TRL N STE 7",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342752162",
            "telephone_number": "941-586-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTE",
        "first_name": "ANGELO",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME78804",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME78804",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME78804",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME78804",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME78804",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nokomis, FL

Sources for this page

Verify at the official NPI Registry.