Individual provider Active NPI

Jake Adam Fontenot, MD

  • Diagnostic Radiology Physician
  • New Orleans, LA
National Provider Identifier
1235715772
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
350538 Issued in LA
Practice address
2000 Canal St
New Orleans, LA 70112-3018
Phone
(504) 702-3000
NPI assigned
Mar 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 350538 LA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2000 Canal St
New Orleans, LA 70112-3018

Mailing address

1542 Tulane Ave # T4M2
New Orleans, LA 70112-2865
Phone (504) 568-5600

Other practice location 1

1542 Tulane Ave # T4M2
New Orleans, LA 70112-2865
Phone (504) 568-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20260613000296 LA Practitioner - Diagnostic Radiology 0244630549

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3000 34TH St
Metairie, LA 70001-2016

478 S Johnson St
New Orleans, LA 70112-2238

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
350538LAMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1235715772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 TULANE AVE # T4M2",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122865",
            "telephone_number": "504-568-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CANAL ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701123018",
            "telephone_number": "504-702-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1542 Tulane Ave # T4M2",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122865",
            "country_code": "US",
            "telephone_number": "504-568-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "JAKE",
        "middle_name": "ADAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "350538",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.