Individual provider Active NPI

Ana Fuentevilla, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Austin, TX
National Provider Identifier
1679554430
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
T9687 Issued in TX
Practice address
500 W William Cannon Dr Ste 400
Austin, TX 78745-5879
Phone
(888) 478-8432
Fax
(737) 707-3908
NPI assigned
Nov 9, 2005
Last updated
May 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X T9687 TX Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 18893 AZ

Addresses

Primary practice location

500 W William Cannon Dr Ste 400
Austin, TX 78745-5879

Mailing address

211 E 7TH St Ste 700
Austin, TX 78701-3218
Phone (888) 478-8432

Other identifiers 1

IdentifierTypeStateIssuer
110643MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200601003172 TX Practitioner - Internal MedicinePractitioner - Geriatric Medicine 8022439926 Reassigns benefits to 2 organizations
I20230425000782 AZ Practitioner - Internal MedicinePractitioner - Geriatric Medicine 8022439926 Reassigns benefits to 1 organization
Practice locations: Tucson, AZ

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T9687TXMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suvida Healthcare Npho CurrentSince Oct 1, 2022 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince May 27, 2020 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince May 27, 2020 Accepting new patients
Suvida Healthcare Clinical Services LLC CurrentSince Aug 29, 2023 Accepting new patients
Suvida Healthcare, LLC PastSince Apr 1, 2023 Accepting new patients
Banner-University Medical Group Past Accepting new patients

Locations

1227 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 613-2967

225 E Valencia Rd
Ste 135
Tucson, AZ 85706
Phone (520) 290-8787

3728 S 16th Ave
Tucson, AZ 85713
Phone (520) 613-2967

211 E 7th St
Ste 700
Austin, TX 78701
Phone (346) 639-3438

2500 W William Cannon Dr
Ste 205
Austin, TX 78745
Phone (512) 445-3366

500 W William Cannon Dr
Ste 400
Austin, TX 78745
Phone (512) 674-0670

Interoperability endpoints

  • Direct secure messaging: ana.fuentevilla@509680731226116.direct.elationemr.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1679554430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E 7TH ST STE 700",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787013218",
            "telephone_number": "888-478-8432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W WILLIAM CANNON DR STE 400",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455879",
            "telephone_number": "888-478-8432",
            "fax_number": "737-707-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTEVILLA",
        "first_name": "ANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "T9687",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AZ",
            "license": "18893",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110643",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.