Manuel Fonseca, MSN, FNP-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11001507 Issued in FL

Practice address

330 Brookline Ave
Boston, MA 02215-5400

Phone

(617) 667-7000

NPI assigned

Jun 30, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18542/brand/1/csg/1/fhir/r4
• Direct secure messaging: manuel.fonseca.1@18542.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.

• Noble Health Insight LLC

  • Primary Care Clinic/Center
  • Wellington, FL
  • NPI 1861376774
  Medicare reassignment NPD Authorized official
• Advanced Cardiovascular Consultants LLC

  • Cardiovascular Disease Physician
  • West Palm Beach, FL
  • NPI 1306329370
  Medicare reassignment NPD

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

{
    "created_epoch": "1561852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1184286122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11737 ANHINGA DR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334145807",
            "telephone_number": "352-215-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "MANUEL",
        "name_prefix": "Mr.",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-30",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "11001507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Boston",
            "affiliation": "Y",
            "affiliationName": "Beth Israel Deaconess Medical Center",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "330 Brookline Ave",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "022155400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tamara G. Fong, M.D., PH.D.
• Yan Hang Fong, MBBS
• Ashfott Fonjungo, MD
• Alexandra Cristina Gomes Fonseca
• Alicia C Fonseca, CNM
• Samuel Alves Fonseca, LCSW
• Jeandrilie Font-Llorens
• Bronte Annette Fontaine
• Nicolette C Fontaine, MD
• Jarilis Fontanez, RN

• Family Medicine Physician in Boston, MA
• Providers in Boston, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.