NPIMap

Individual provider Active NPI

Hiyas Dungo Fonte, M.D.

  • Internal Medicine Physician
  • Southlake, TX
National Provider Identifier
1669405064
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M6618 Issued in TX
Practice address
731 E Southlake Blvd
Suite 100
Southlake, TX 76092-6377
Phone
(817) 912-8800
Fax
(817) 912-8810
NPI assigned
Jul 9, 2006
Last updated
Jun 11, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4946929-1205 UT
Internal Medicine Physician 207R00000X M6618 TX Primary

Addresses

Primary practice location

731 E Southlake Blvd
Suite 100
Southlake, TX 76092-6377

Mailing address

731 E Southlake Blvd
Suite 100
Southlake, TX 76092-6377
Phone (817) 912-8800

Other identifiers 1

IdentifierTypeStateIssuer
187761501MedicaidTX

Other names 1

  • Hiyas D. Fonte Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071024000203 TX Practitioner - Internal Medicine 9830285725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
George Washington University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1650 W College St
Grapevine, TX 76051-3565
Phone (817) 388-3440

4001 Worth St
Dallas, TX 75246-1608

5408 Colleyville Blvd
Colleyville, TX 76034-5833
Phone (817) 498-9920

731 E Southlake Blvd
Suite 100
Southlake, TX 76092-6378
Phone (817) 424-3366

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M6618TXMDInternal Medicine Physician
4946929-1205UTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jul 1, 2007 Accepting new patients
Healthtexas Provider Network Internal Medicine CurrentSince Jul 1, 2007 Accepting new patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (469) 800-8648

731 E Southlake Blvd
Ste 100
Southlake, TX 76092
Phone (817) 424-3366

Interoperability endpoints

  • Direct secure messaging: hfonte224917@direct.sw.org

Organizations & group practices 4

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 8

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1669405064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 E SOUTHLAKE BLVD",
            "address_2": "SUITE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926377",
            "telephone_number": "817-912-8800",
            "fax_number": "817-912-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 E SOUTHLAKE BLVD",
            "address_2": "SUITE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926377",
            "telephone_number": "817-912-8800",
            "fax_number": "817-912-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTE",
        "first_name": "HIYAS",
        "middle_name": "DUNGO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "4946929-1205",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M6618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187761501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HIYAS",
            "last_name": "FONTE",
            "middle_name": "D.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.