Individual provider Active NPI

Christopher Jorge Da Fonseca, M.D.

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1194168104
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME121862 Issued in FL
Practice address
12314 SW 127TH Ave
Miami, FL 33186-6579
Phone
(786) 595-8080
Fax
(786) 533-9381
NPI assigned
Apr 9, 2013
Last updated
Jul 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME121862 FL Primary

Addresses

Primary practice location

12314 SW 127TH Ave
Miami, FL 33186-6579

Mailing address

PO Box 198054
Atlanta, GA 30384-8054
Phone (786) 595-8080

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address christopd@cerner.directbaptisthealth.com

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160926001996 FL Practitioner - Family Practice 9436446044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Miami, LM Miller School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group Physicians LLCGroup PAC ID 3870696933, 661 clinicians

Practice addresses (Care Compare)

20989 Old Cutler Rd
Cutler Bay, FL 33189-2469
Phone (786) 595-1750

6200 Sunset Dr
Suite 604
South Miami, FL 33143-4831
Phone (786) 662-8928

6200 SW 72 St
Suite 602
South Miami, FL 33143-4831
Phone (786) 662-0600

6200 SW 72ND St Mci Benign Urology
Suite 601
South Miami, FL 33143-4831
Phone (786) 596-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.99 of 100Reported as apm
Quality
81.94
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Physicians, LLC CurrentSince Jul 24, 2022 Accepting new patients
Baptist Health Medical Group Physicians LLC CurrentSince Aug 22, 2016 Accepting new patients

Locations

12314 SW 127th Ave
Miami, FL 33186
Phone (305) 333-5230

6200 Sunset Dr
Ste 604
South Miami, FL 33143
Phone (305) 853-9240

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1194168104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198054",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848054",
            "telephone_number": "786-595-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12314 SW 127TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331866579",
            "telephone_number": "786-595-8080",
            "fax_number": "786-533-9381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DA FONSECA",
        "first_name": "CHRISTOPHER",
        "middle_name": "JORGE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-09",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME121862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christopd@cerner.directbaptisthealth.com",
            "affiliation": "N",
            "address_1": "12314 SW 127th Ave",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331866579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.