Individual provider Active NPI

Alphonso Fontaine, PA

  • Medical Physician Assistant
  • Clearwater, FL
National Provider Identifier
1407806573
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00002737 Issued in FL
Practice address
2250 Drew St
Clearwater, FL 33765-3305
Phone
(727) 724-5600
Fax
(727) 724-5689
NPI assigned
May 11, 2006
Last updated
Feb 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00002737 FL Primary

Addresses

Primary practice location

2250 Drew St
Clearwater, FL 33765-3305

Mailing address

PO Box 850001
Orlando, FL 32885-0254
Phone (727) 724-5600

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100310000718 FL Practitioner - Physician Assistant 4183769482 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Anesthesia Associates LLCGroup PAC ID 4183619828, 47 clinicians

Practice addresses (Care Compare)

401 Corbett St
Suite 330
Belleair, FL 33756-7312
Phone (866) 724-6807

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.12 of 100Reported as group
Quality
71.03
Promoting interoperability
100
Improvement activities
40
Cost
83.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00002737FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Florida Anesthesiologists, LLC CurrentSince Jan 1, 2016 Accepting new patients
Baptist Surgery and Endoscopy Centers LLC CurrentSince Jan 30, 2024 Accepting new patients
Greater Florida Anesthesiologists, LLC CurrentSince Jan 1, 2016 Accepting new patients
Anesthesia Dynamics LLC PastSince Jan 30, 2024 Accepting new patients
The Clearwater Orthopaedic ASC LLC Past Accepting new patients
Fleming Island Anesthesia LLC PastSince Jan 30, 2024 Accepting new patients

Locations

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

430 Morton Plant St
Ste 210
Clearwater, FL 33756
Phone (727) 443-0611

93 N Park Place Blvd
Ste 102
Clearwater, FL 33759
Phone (727) 240-2088

900 Carillon Pkwy
Ste 205
St Petersburg, FL 33716
Phone (727) 561-2710

325 Avenue B NW
Winter Haven, FL 33881
Phone (800) 364-9216

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: alphonso.fontaine.1@30104.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1407806573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850001",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328850254",
            "telephone_number": "727-724-5600",
            "fax_number": "727-724-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 DREW ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653305",
            "telephone_number": "727-724-5600",
            "fax_number": "727-724-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTAINE",
        "first_name": "ALPHONSO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA00002737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.