Individual provider Active NPI

Sara Ilana Fontanez, M.D.

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1184004889
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
295358 Issued in NY
Practice address
1114 Liberty Ave
Brooklyn, NY 11208-2922
Phone
(718) 765-6058
Fax
(347) 808-4895
NPI assigned
Jun 8, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 295358 NY
Family Medicine Physician 207Q00000X 87338 WI
Family Medicine Physician 207Q00000X 295358 NY Primary

Addresses

Primary practice location

1114 Liberty Ave
Brooklyn, NY 11208-2922

Mailing address

PO Box 746087
Atlanta, GA 30374-6087
Phone (312) 733-9730

Other practice location 1

800 West Ave S
La Crosse, WI 54601-8806
Phone (608) 785-0940

Other practice location 2

101 Nicolls Rd
Stony Brook, NY 11794-2401
Phone (314) 448-4786

Other practice location 3

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-7441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA, WI3 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

Enrollment IDStateProvider typePAC IDDetails
I20180904000493 NY Practitioner - Family PracticePractitioner - Hospitalist 8325398985 Reassigns benefits to 1 organization
I20250909000888 MA Practitioner - Family Practice 8325398985 Reassigns benefits to 1 organization
I20260506002880 WI Practitioner - Family Practice 8325398985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mass General Brigham Community Physicians IncGroup PAC ID 1759273436, 430 clinicians
Mayo Clinic Health System-Southwest Wisconsin Region IncGroup PAC ID 0345152443, 539 clinicians

Practice addresses (Care Compare)

101 Main St
Medford, MA 02155-4530
Phone (781) 395-4761

170 Governors Ave
Medford, MA 02155-1643
Phone (781) 395-4909

800 W Ave S
La Crosse, WI 54601-8806
Phone (608) 785-0940

Hospital & facility affiliations

  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
87338WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Sep 13, 2019 Accepting new patients
Mass General Brigham Community Physicians Inc CurrentSince Sep 1, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Sep 13, 2019 Accepting new patients
Mass General Brigham Community Physicians Inc. Past Accepting new patients

Locations

101 Main St
Ste 107
Medford, MA 02155
Phone (781) 391-4004

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

399 Revolution Dr
Ste 1010
Somerville, MA 02145
Phone (857) 282-2063

111 E 210th St
Bronx, NY 10467

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1184004889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746087",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 LIBERTY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112082922",
            "telephone_number": "718-765-6058",
            "fax_number": "347-808-4895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 West Ave S",
            "address_purpose": "LOCATION",
            "city": "La Crosse",
            "state": "WI",
            "postal_code": "546018806",
            "country_code": "US",
            "telephone_number": "608-785-0940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Nicolls Rd",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117942401",
            "country_code": "US",
            "telephone_number": "314-448-4786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-7441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONTANEZ",
        "first_name": "SARA",
        "middle_name": "ILANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "295358",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "87338",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "295358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.