NPIMap

Individual provider Active NPI

David W Fontaine, MD

  • Diagnostic Radiology Physician
  • Bedford, NH
National Provider Identifier
1346205184
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
11108 Issued in NH
Practice address
703 Riverway PL
Bedford, NH 03110-6768
Phone
(603) 668-7096
Fax
(603) 669-6944
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 11108 NH Primary

Addresses

Primary practice location

703 Riverway PL
Bedford, NH 03110-6768

Mailing address

703 Riverway PL
Bedford, NH 03110-6745
Phone (603) 627-1661

Other identifiers 7

IdentifierTypeStateIssuer
294664OtherNHCIGNA
01Y002791NH02OtherNHBLUE CROSS
101250OtherNHTUFTS
300113664OtherNHRAILROAD MEDICARE
2486283OtherNHAETNA
01Y002791 NH05OtherNHANTHEM MCH TAX ID
30201186MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, SC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20040816000087 NH Practitioner - Diagnostic Radiology 1759354103 Reassigns benefits to 3 organizations
I20250115001664 SC Practitioner - Diagnostic Radiology 1759354103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Boston University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern New Hampshire Radiology Consultants PCGroup PAC ID 2769436088, 39 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 633-2541

100 McGregor St
Manchester, NH 03102-3730
Phone (603) 663-6623

11 Washington PL
Suite 1
Bedford, NH 03110-6747
Phone (603) 622-3670

16 Hospital Rd
Plymouth, NH 03264-1126
Phone (603) 238-2215

59 Page Hill Rd
Berlin, NH 03570-3531
Phone (603) 752-2200

703 Riverway PL
Bedford, NH 03110-6768
Phone (603) 627-1661

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Littleton Hospital Association CurrentSince Jan 30, 2016 Accepting new patients
Littleton Hospital Association CurrentSince Jan 30, 2016 Accepting new patients
Portsmouth Radiological, PA Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Southern New Hampshire Radiology Consultants PC Diagnostic Radiology CurrentSince Jan 1, 2003 Accepting new patients
Rhode Island Medical Imaging Inc Diagnostic Radiology PastSince Jun 26, 2022 Accepting new patients
Rhode Island Medical Imaging Inc Diagnostic Radiology Past Accepting new patients

Locations

703 Riverway Pl
Bedford, NH 03110
Phone (603) 668-7096

600 Saint Johnsbury Rd
Littleton, NH 03561
Phone (603) 444-9000

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

100 McGregor St
Manchester, NH 03102
Phone (603) 663-6931

8 Prospect St
Nashua, NH 03060
Phone (603) 281-9275

452 Old Street Rd
Peterborough, NH 03458
Phone (603) 924-4699

16 Hospital Rd
Plymouth, NH 03264
Phone (603) 238-2229

333 Bothwick Ave
Portsmouth, NH 03801
Phone (603) 433-4907

Organizations & group practices 6

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 10

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1346205184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 RIVERWAY PL",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106745",
            "telephone_number": "603-627-1661",
            "fax_number": "603-669-6944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 RIVERWAY PL",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106768",
            "telephone_number": "603-668-7096",
            "fax_number": "603-669-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTAINE",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NH",
            "license": "11108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "294664",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "01Y002791NH02",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "101250",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300113664",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2486283",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM MCH TAX ID",
            "identifier": "01Y002791 NH05",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30201186",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

Verify at the official NPI Registry.