Gregory Anthony Fonzo, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY27812 Issued in CA

Practice address

870 Market St
Suite 958
San Francisco, CA 94102-3099

Phone

(650) 394-6586

NPI assigned

Oct 9, 2009

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

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The University of Texas at AustinGroup PAC ID 2668559436, 154 clinicians

University of Texas at Austin Dell Medical SchoolGroup PAC ID 7113401340, 144 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Interoperability endpoints

• Direct secure messaging: gregory.fonzo.1@16041.direct.athenahealth.com

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.

• University of Texas at Austin Dell Medical School

  • General Practice Physician
  • Austin, TX
  • NPI 1073066239
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1174858070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 MARKET ST",
            "address_2": "SUITE 958",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941023099",
            "telephone_number": "650-394-6586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 MARKET ST",
            "address_2": "SUITE 958",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941023099",
            "telephone_number": "650-394-6586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONZO",
        "first_name": "GREGORY",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-09",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rina Fontanilla
• Sophia Fontano
• Dana Putnam Fonteneau, M.M., M.A.
• Alfred Paul Fontenot, LPT
• Kathryn Fontwit, PA
• Louise Hoi Yee Foo, PH.D.
• Simpson Foo, RPH
• Foodsmart Nutrition Network of New Jersey, P.C.
• David W. Foon, DDS
• Christopher Foor

• Clinical Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; 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.