Shane Bennett Fontenot, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1540 Issued in LA

Practice address

1702 Johnson St
Jennings, LA 70546-3624

Phone

(337) 824-1112

Fax

(337) 824-9112

NPI assigned

Jul 31, 2007

Last updated

Oct 7, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Family Eyecare LLCGroup PAC ID 1658464268, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

73.63 of 100Reported as individual

Quality

63.51

Promoting interoperability

79

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sfontenot1657292@direct.ochsner.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Family Eyecare, LLC

  dba Advanced Family Eyecare

  • Optometrist
  • Jennings, LA
  • NPI 1215121652
  Medicare reassignment Care Compare group NPD Authorized official
• Acadiana Optics LLC

  • Optometrist
  • Broussard, LA
  • NPI 1770264640
  NPD
• Jason Wonch, O.D. and Associates, a.P.C.

  dba Visionworks

  • Optometrist
  • Lake Charles, LA
  • NPI 1295769008
  NPD (past)

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1164612529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 JOHNSON ST",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463624",
            "telephone_number": "337-824-1112",
            "fax_number": "337-824-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 JOHNSON ST",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463624",
            "telephone_number": "337-824-1112",
            "fax_number": "337-824-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "SHANE",
        "middle_name": "BENNETT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-31",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020818",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Migdalia Fontanez, MD
• Dustin Paul Fontenot, P.T.
• Jana D Fontenot, PT
• Katlyn Hanks Fontenot, M. ED, BCBA, LBA
• Reney Reed Fontenot, APRN, PMHNP-BC
• Tyler J. M. Fontenot, DPT
• William Dean Fontenot, C.R.N.A.
• Jillian Duhon Franklin, OD
• Free Spirit Transportation LLC
• Emily Fruge, PT

• Optometrist in Jennings, LA
• Providers in Jennings, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.