Individual provider Active NPI

Fidencio T Alanis, MD

  • Pediatrics Physician
  • Oregon, OH
National Provider Identifier
1184741266
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35034517 Issued in OH
Practice address
3156 Dustin Rd
Suite 401
Oregon, OH 43616-4353
Phone
(419) 729-5427
Fax
(419) 729-5428
NPI assigned
Mar 23, 2007
Last updated
Jul 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35034517 OH Primary

Addresses

Primary practice location

3156 Dustin Rd
Suite 401
Oregon, OH 43616-4353

Mailing address

3156 Dustin Rd Ste 401
Oregon, OH 43616-4358
Phone (419) 698-8660

Other identifiers 1

IdentifierTypeStateIssuer
0199057MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35034517OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1184741266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3156 DUSTIN RD STE 401",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436164358",
            "telephone_number": "419-698-8660",
            "fax_number": "419-698-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3156 DUSTIN RD",
            "address_2": "SUITE 401",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436164353",
            "telephone_number": "419-729-5427",
            "fax_number": "419-729-5428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALANIS",
        "first_name": "FIDENCIO",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35034517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0199057",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.