Robert Fontanilla, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA52552 Issued in CA

Practice address

1970 University Ave
Riverside, CA 92507-5202

Phone

(833) 867-4642

Fax

(360) 462-5825

NPI assigned

Jun 15, 2015

Last updated

Dec 11, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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 CA, IL2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dap Health IncGroup PAC ID 6002989522, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: rfontanilla704894@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dap Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Palm Springs, CA
  • NPI 1306464326
  Medicare reassignment Care Compare group
• Neighborhood Healthcare

  dba Neighborhood Healthcare - Escondido

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1598703647
  Medicare reassignment NPD
• AIDS Services Foundation Orange County

  dba Radiant Health Centers

  • Federally Qualified Health Center (FQHC)
  • Irvine, CA
  • NPI 1932223781
  Medicare reassignment
• Doctors on Site, LTD

  • General Practice Physician
  • South Barrington, IL
  • NPI 1720410483
  Medicare reassignment
• Neighborhood Healthcare

  dba Neighborhood Healthcare - Beaumont

  • Federally Qualified Health Center (FQHC)
  • Beaumont, CA
  • NPI 1629601653
  NPD

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1184005258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 UNIVERSITY AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925075202",
            "telephone_number": "833-867-4642",
            "fax_number": "360-462-5825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 UNIVERSITY AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925075202",
            "telephone_number": "833-867-4642",
            "fax_number": "360-462-5825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANILLA",
        "first_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-15",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA52552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Voy K Fong, DPT
• Emelda Makochi Fonki, MPH
• Cristian Fonseca
• Marie Therese Fonseca, CADACI
• Haylee Nichole Fontaine, AMFT
• Cliff Fontelera, CRNA
• Emily Foote
• Allyson Ford
• Carla Ford, CADC
• Cedrina Ford

• Physician Assistant in Riverside, CA
• Providers in Riverside, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.