NPIMap

Organization Active NPI

Robert G. Fante MD, PC

  • Ophthalmology Physician
  • Denver, CO
National Provider Identifier
1174702575
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
37140 Issued in CO
Legal business name
ROBERT G. FANTE MD, PC
Practice address
4500 Cherry Creek Dr. S.
Suite 550
Denver, CO 80246-1524
Phone
(303) 839-1616
Fax
(303) 839-1991
NPI assigned
Nov 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Authorized official

Name
Dr. Robert Glenn Fante, MDNPI 1932190121
Title
Medical Director
Phone
(303) 839-1616

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X 37140 CO Primary
Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2082S0099X 37140 CO

Addresses

Primary practice location

4500 Cherry Creek Dr. S.
Suite 550
Denver, CO 80246-1524

Mailing address

4500 Cherry Creek Dr. S.
Suite 550
Denver, CO 80246-1524
Phone (303) 839-1616

Other identifiers 1

IdentifierTypeStateIssuer
34939725MedicaidCO

Other names 1

  • Fante Eye and Face Centre Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040921000053 CO Part B Supplier - Clinic/Group Practice 1052389715 Receives reassigned benefits from 4 practitioners
Practice locations: Denver, CO
O20041014000506 KS Part B Supplier - Clinic/Group Practice 1052389715 Receives reassigned benefits from 2 practitioners
Practice locations: Goodland, KS

National Provider Directory

National Provider Directory

Locations

4500 E Cherry Creek South Dr
Ste 550
Denver, CO 80246
Phone (303) 839-1616

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1174702575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 CHERRY CREEK DR. S.",
            "address_2": "SUITE 550",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802461524",
            "telephone_number": "303-839-1616",
            "fax_number": "303-839-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 CHERRY CREEK DR. S.",
            "address_2": "SUITE 550",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802461524",
            "telephone_number": "303-839-1616",
            "fax_number": "303-839-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT G. FANTE MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "FANTE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "303-839-1616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "37140",
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "CO",
            "license": "37140",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34939725",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fante Eye and Face Centre",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fante Eye and Face Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.