NPIMap

Individual provider Active NPI

Adam Fonseca, M.D.

  • Vascular & Interventional Radiology Physician
  • Maywood, IL
National Provider Identifier
1285053546
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
036.152613 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(708) 216-5204
NPI assigned
Apr 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X LA
Vascular & Interventional Radiology Physician 2085R0204X 036.152613 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
Maywood, IL 60153-3328

Other practice location 1

1430 Tulane Ave # Sl-22
Tulane University, Department of Surgery
New Orleans, LA 70112-2632
Phone (504) 988-5128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IL, AZ3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20221206001541 TX Practitioner - Diagnostic Radiology 0345619896 Reassigns benefits to 4 organizations
I20231214003211 IL Practitioner - Diagnostic Radiology 0345619896 Reassigns benefits to 2 organizations
I20260429002760 AZ Practitioner - Diagnostic Radiology 0345619896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Louisiana State University School of Medicine in New Orleans, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montrose Memorial Hospital, IncGroup PAC ID 1658272992, 148 clinicians
Sonoran Radiology LTDGroup PAC ID 3375964505, 466 clinicians
Eagle Partners, PLLCGroup PAC ID 9032205752, 170 clinicians
Singleton Associates PAGroup PAC ID 6305731118, 814 clinicians

Practice addresses (Care Compare)

Houston, TX 77007
Phone (504) 583-3544

1440 S Villa Ave
Villa Park, IL 60181-3405
Phone (623) 299-8743

8010 Ivan Reid Dr
Houston, TX 77040-2556
Phone (405) 923-1296

9250 Pinecroft Dr
Shenandoah, TX 77380-3218
Phone (713) 897-2300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.152613ILMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Radiology Associates PLLC CurrentSince Nov 15, 2023 Accepting new patients
Sonoran Radiology LTD Vascular & Interventional Radiology CurrentSince Oct 2, 2023 Accepting new patients
Singleton Associates PA Vascular & Interventional Radiology CurrentSince Aug 20, 2022 Accepting new patients
Eagle Partners, PLLC Vascular & Interventional Radiology CurrentSince Sep 19, 2025 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Singleton Associates PA Vascular & Interventional Radiology CurrentSince Aug 20, 2022 Accepting new patients
Montrose Memorial Hospital, Inc CurrentSince Dec 20, 2024 Accepting new patients
Synergy Radiology Associates PastSince Jun 11, 2023 Accepting new patients
Community Radiology Associates P a Vascular & Interventional Radiology Past Accepting new patients

Locations

8310 W Camelback Rd
Glendale, AZ 85305
Phone (480) 307-9610

5171 W Olive Ave
Glendale, AZ 85302
Phone (480) 732-7540

251 N Estrella Pkwy
Goodyear, AZ 85338
Phone (623) 322-6900

7171 S 51st Ave
Laveen, AZ 85339
Phone (623) 584-5100

9130 E Elliot Rd
Mesa, AZ 85212
Phone (480) 410-4500

1201 S Alma School Rd
Ste 14500
Mesa, AZ 85210
Phone (602) 698-7715

800 S 3rd St
Montrose, CO 81401
Phone (970) 240-2211

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

9440 Poppy Dr
Dallas, TX 75218
Phone (214) 324-6100

1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845

6720 Bertner Ave
#2270
Houston, TX 77030
Phone (832) 355-4092

7026 Old Katy Rd
Ste 276
Houston, TX 77024
Phone (713) 358-0562

6720 Bertner Ave
#270
Houston, TX 77030
Phone (832) 355-4092

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

9155 Grapevine Hwy
Ste 120
North Richland Hills, TX 76180

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

Interoperability endpoints

  • Direct secure messaging: afonseca36313@memorialhermann.direct-ci.com
  • Direct secure messaging: afonseca125899@direct.luhs.org

Organizations & group practices 9

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.

Hospital & facility affiliations 11

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1285053546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-5204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1430 Tulane Ave # Sl-22",
            "address_2": "Tulane University, Department of Surgery",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122632",
            "country_code": "US",
            "telephone_number": "504-988-5128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036.152613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.