Active NPI
Cameron James Fontenot, MD
- Neurological Surgery Physician
- Philadelphia, PA
National Provider Identifier
1609703628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- MT236410
- Practice address
- 3401 N Broad St
Philadelphia, PA 19140-5189 - Phone
- (800) 836-7536
- NPI assigned
- May 5, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | MT236410 | PA | Primary |
Addresses
Primary practice location
3401 N Broad St
Philadelphia, PA 19140-5189
Mailing address
242 E Bayou Rd
Thibodaux, LA 70301-2941
Phone (985) 714-4673
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260530000323 | PA | Order and Referring Only - Neurosurgery | 0941770986 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT236410 | PA | MD | Neurological Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777939200000",
"number": "1609703628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 E BAYOU RD",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703012941",
"telephone_number": "985-714-4673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405189",
"telephone_number": "800-836-7536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTENOT",
"first_name": "CAMERON",
"middle_name": "JAMES",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-05-05",
"last_updated": "2026-05-05",
"certification_date": "2026-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "PA",
"license": "MT236410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.