Regine Marie Fortunov, MD

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

N6299 Issued in TX

Practice address

6701 Fannin St
Houston, TX 77030-2608

Phone

(832) 824-1000

NPI assigned

Mar 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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

State licenses

Practice roles

Locations

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.

• Baylor College of Medicine

  • Family Medicine Physician
  • Houston, TX
  • NPI 1053352914
  Medicare reassignment NPD
• Baylor College of Medicine

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1104867175
  NPD
• Texas Children'S Hospital

  • Children's Hospital
  • Houston, TX
  • NPI 1477643690
  NPD (past)
• Texas Children'S Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1174653026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GREENWAY PLZ STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460207",
            "telephone_number": "832-828-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302608",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNOV",
        "first_name": "REGINE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "AZ",
            "license": "86-0256641",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "N6299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEONATAL RESUSITATIO",
            "identifier": "605-6530",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ MEDICAL LICENSE",
            "identifier": "36625",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LICENSE",
            "identifier": "N6299",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fortune Healthcare, Inc
• Fortune Healthcare, Inc
• Fortune Phi, PA
• John E Fortune, CRNA
• Ryan Dean Fortune
• Forum Healthcare Clinic Inc.
• Forward Faith Behavioral Services
• Forward Mobile Medics, LLC
• Forward Path DX Lab LLC
• Forward Thinking LLC

• Neonatal-Perinatal Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Neonatal-Perinatal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.