Individual provider Active NPI

Don J. Fontana, M.D.

  • Plastic Surgery Physician
  • Waldorf, MD
National Provider Identifier
1124003421
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
D0023431 Issued in MD
Practice address
3500 Old Washington Rd.
Suite 201
Waldorf, MD 20602-3238
Phone
(301) 870-0600
Fax
(301) 870-0609
NPI assigned
Dec 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 22431 NH
Plastic Surgery Physician 208200000X MD10918 DC
Plastic Surgery Physician 208200000X 2909 WI
Plastic Surgery Physician 208200000X D0023431 MD Primary

Addresses

Primary practice location

3500 Old Washington Rd.
Suite 201
Waldorf, MD 20602-3238

Mailing address

3500 Old Washington Rd.
Suite 201
Waldorf, MD 20602-3238
Phone (301) 870-0600

Other practice location 1

246 Pleasant St Ste 210
Concord, NH 03301-2548
Phone (603) 224-5200

Other practice location 2

130 2nd St
Neenah, WI 54956-2883
Phone (920) 729-3100

Other identifiers 1

IdentifierTypeStateIssuer
3282DJOtherMDBCBS MD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2909WIMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliates in Plastic Surgery, LLC Plastic Surgery CurrentSince Mar 1, 2022 Accepting new patients
Thedacare, Incorporated CurrentSince Mar 24, 2023 Accepting new patients
Affiliates in Plastic Surgery, LLC CurrentSince Mar 1, 2022 Accepting new patients

Locations

5530 Wisconsin Ave
Ste 711
Chevy Chase, MD 20815
Phone (301) 232-3000

4660 Kenmore Ave
Ste 220
Alexandria, VA 22304
Phone (703) 832-4000

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Interoperability endpoints

  • Direct secure messaging: dfontana330621@direct.thedacare.org

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": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1124003421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 OLD WASHINGTON RD.",
            "address_2": "SUITE 201",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023238",
            "telephone_number": "301-870-0600",
            "fax_number": "301-870-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 OLD WASHINGTON RD.",
            "address_2": "SUITE 201",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023238",
            "telephone_number": "301-870-0600",
            "fax_number": "301-870-0609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "246 Pleasant St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NH",
            "postal_code": "033012548",
            "country_code": "US",
            "telephone_number": "603-224-5200",
            "fax_number": "603-227-7559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 2nd St",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549562883",
            "country_code": "US",
            "telephone_number": "920-729-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONTANA",
        "first_name": "DON",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NH",
            "license": "22431",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "DC",
            "license": "MD10918",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WI",
            "license": "2909",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MD",
            "license": "D0023431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "3282DJ",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.