Active NPI
Mark Paul Fontes, APRN
- Nurse Practitioner
- Warwick, RI
National Provider Identifier
1710546783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN02080
- Practice address
- 475 Kilvert St
Warwick, RI 02886-1379 - Phone
- (401) 732-7116
- Fax
- (884) 813-8700
- NPI assigned
- Jun 12, 2019
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN02080 | RI | Primary |
Addresses
Primary practice location
475 Kilvert St
Warwick, RI 02886-1379
Mailing address
179 Blackrock Rd
Coventry, RI 02816-8007
Phone (401) 615-2037
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200228001417 | RI | Order and Referring Only - Nurse Practitioner | 8527495746 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN02080 | RI | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560297600000",
"number": "1710546783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "179 BLACKROCK RD",
"city": "COVENTRY",
"state": "RI",
"postal_code": "028168007",
"telephone_number": "401-615-2037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 KILVERT ST",
"city": "WARWICK",
"state": "RI",
"postal_code": "028861379",
"telephone_number": "401-732-7116",
"fax_number": "884-813-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTES",
"first_name": "MARK",
"middle_name": "PAUL",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-12",
"last_updated": "2019-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "RI",
"license": "APRN02080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warwick, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.