Individual provider Active NPI

Kevin John Fontenot, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1710991807
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP110669 Issued in TX
Practice address
4916 Overton PLZ
Fort Worth, TX 76109
Phone
(817) 529-1144
Fax
(817) 334-0235
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 651941 TX
Certified Registered Nurse Anesthetist 367500000X AP110669 TX Primary

Addresses

Primary practice location

4916 Overton PLZ
Fort Worth, TX 76109

Mailing address

1043 Fox Wood Dr
Kennedale, TX 76060-6472
Phone (817) 307-0459

Other practice location 1

12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Phone (972) 715-5000

Other identifiers 1

IdentifierTypeStateIssuer
002422602MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071127000294 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193813277 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Baylor College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians
Endo Sedation LLCGroup PAC ID 4789845363, 289 clinicians

Practice addresses (Care Compare)

2411 Fountain View Dr
Suite 200
Houston, TX 77057-4832
Phone (713) 620-4000

900 W Magnolia Ave
Suite 101
Fort Worth, TX 76104-8518
Phone (817) 332-6500

Merit-based Incentive Payment System (MIPS)

Final score
88.94 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
651941TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 5, 2024 Accepting new patients
U S Anesthesia Partners of Texas, PA Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2015 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2015 Accepting new patients
Best Choice Anesthesia & Pain PLLC CurrentSince Aug 25, 2013 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 5, 2024 Accepting new patients
Anesthesiology Consultants of North Texas PA Nurse Anesthetist, Certified Registered CurrentSince Jan 31, 2018 Accepting new patients
Valiant Anesthesia Associates, PLLC CurrentSince Mar 1, 2024 Accepting new patients
Baylor College of Medicine Past Accepting new patients

Locations

700 Highlander Blvd
Ste 415
Arlington, TX 76015
Phone (817) 330-1102

14850 Quorum Dr
Ste 400
Dallas, TX 75254
Phone (214) 801-1879

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844

1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671

3455 Locke Ave
Fort Worth, TX 76107
Phone (214) 284-7106

900 W Magnolia Ave
Ste 101
Fort Worth, TX 76104
Phone (817) 332-6500

975 Haskell St
Ft Worth, TX 76107
Phone (817) 334-5113

1800 Park Place Ave
Ft Worth, TX 76110
Phone (682) 703-5600

1021 Holden St
Glen Rose, TX 76043
Phone (254) 897-1425

7010 Champions Plaza Dr
Ste 300
Houston, TX 77069
Phone (832) 698-5320

2411 Fountain View Dr
Ste 200
Houston, TX 77057
Phone (713) 458-4185

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

180 Bear Creek Pkwy
Keller, TX 76248
Phone (817) 337-3671

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

Interoperability endpoints

  • Direct secure messaging: kfontenot@direct.uspi.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1710991807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 FOX WOOD DR",
            "city": "KENNEDALE",
            "state": "TX",
            "postal_code": "760606472",
            "telephone_number": "817-307-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4916 OVERTON PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76109",
            "telephone_number": "817-529-1144",
            "fax_number": "817-334-0235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12222 Merit Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752513294",
            "country_code": "US",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "KEVIN",
        "middle_name": "JOHN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "651941",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP110669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002422602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.