Roderick W Fontenette, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

147303 Issued in CA

Practice address

101 Bodin Cir
Central Credentialing
Travis Afb, CA 94535-1809

Phone

(707) 423-3000

NPI assigned

Sep 23, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN, LA, CA3 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 3

Specialty

Emergency Medicine

Education

Louisiana State University School of Medicine in Shreveport, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Emergency PhysiciansGroup PAC ID 4284171166, 47 clinicians

Inpatient Specialists of California PCGroup PAC ID 3476864448, 373 clinicians

Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health St Helena Hospital, Saint Helena, CA, CCN 050013
• University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599
• Shasta Regional Medical Center Hospital, Redding, CA, CCN 050764
• Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317
• Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301

Merit-based Incentive Payment System (MIPS)

Final score

83.15 of 100Reported as group

Quality

64.8

Promoting interoperability

100

Improvement activities

40

Cost

68.65

Merit-based Incentive Payment System (MIPS)

Final score

96.69 of 100Reported as group

Quality

90

Improvement activities

40

Cost

78.43

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 29)

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.

• Inpatient Specialists of California, PC

  • Internal Medicine Physician
  • San Bernardino, CA
  • NPI 1952792475
  Medicare reassignment Care Compare group NPD
• Regents of the Univ of Ca

  • Maternal & Fetal Medicine Physician
  • Sacramento, CA
  • NPI 1013906973
  Medicare reassignment Care Compare group NPD
• Trinity Emergency Physicians

  • Emergency Medicine Physician
  • Redding, CA
  • NPI 1508605635
  Medicare reassignment Care Compare group NPD
• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment NPD
• San Francisco Physicians International Medical Group, Inc

  • Emergency Medicine Physician
  • San Ramon, CA
  • NPI 1841220720
  Medicare reassignment NPD
• Coolidge Emergency Group LLC

  • Emergency Medicine Physician
  • Lafayette, LA
  • NPI 1801140934
  Medicare reassignment NPD
• Indiana University Health Care Associates, Inc

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1902032832
  Medicare reassignment NPD
• Main Street Emergency Group LLC

  • Emergency Medicine Physician
  • New Iberia, LA
  • NPI 1750796041
  Medicare reassignment NPD
• St Mary Emergency Group LLC

  • Emergency Medicine Physician
  • Morgan City, LA
  • NPI 1235108499
  Medicare reassignment NPD
• Cep America - California

  • Emergency Medicine Physician
  • Sacramento, CA
  • NPI 1215281233
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Pura Vida Recovery Services, LLC

  • Substance Abuse Rehabilitation Facility
  • Santa Rosa, CA
  • NPI 1346025343
  NPD

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

• Adventist Health Clearlake Hospital Inc.

  • Critical Access Hospital
  • Clearlake, CA
  • NPI 1124018031
  Care Compare affiliation
• Prime Healthcare Services - Shasta LLC

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1205089026
  Care Compare affiliation
• Regents of the University of California

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1710918545
  Care Compare affiliation
• St. Helena Hospital

  • General Acute Care Hospital
  • Saint Helena, CA
  • NPI 1720078082
  Care Compare affiliation
• Ukiah Adventist Hospital

  • General Acute Care Hospital
  • Ukiah, CA
  • NPI 1235120676
  Care Compare affiliation

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1164672499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "address_2": "CENTRAL CREDENTIALING",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "address_2": "CENTRAL CREDENTIALING",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "231 Albert Sabin Way",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452672827",
            "country_code": "US",
            "telephone_number": "513-558-5281",
            "fax_number": "513-558-5791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONTENETTE",
        "first_name": "RODERICK",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-23",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01069587A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35 096666",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD.203768",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "147303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201021810",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edmund R Florendo, MD
• Anthony Flores
• Rebecca Lee Flores, IDMT
• Isabel Fong, PHARMD
• Corina Jude Fontelera
• Robin E Fontenot, DDS
• Sara Marie Forrest Jaimes, CNM
• Samantha Forrest, OTR/L
• Steven A Forsythe, DDS
• Brian A Fortier, LCSW

• Emergency Medicine Physician in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; 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.