NPIMap

Individual provider Active NPI

John Fontaine, MD

  • Cardiovascular Disease Physician
  • Philadelphia, PA
National Provider Identifier
1811945017
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD042292L Issued in PA
Practice address
219 N Broad St
2ND Floor
Philadelphia, PA 19107-1519
Phone
(215) 762-5080
Fax
(215) 561-8071
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD042292L PA Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X MD042292L PA

Addresses

Primary practice location

219 N Broad St
2ND Floor
Philadelphia, PA 19107-1519

Mailing address

1601 Cherry St
Suite 11511
Philadelphia, PA 19102-1321
Phone (215) 255-7822

Other identifiers 1

IdentifierTypeStateIssuer
001214146MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061128000024 PA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Cardiac Electrophysiology 9335147479 Reassigns benefits to 3 organizations
I20210330000364 FL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 9335147479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Rutgers, Robert Woood Johnson Medical School, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians

Practice addresses (Care Compare)

740 High St
Suite 2001
Williamsport, PA 17701-3102
Phone (570) 321-2800

Hospital & facility affiliations

  • Upmc Williamsport Hospital, Williamsport, PA, CCN 390045
  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Jun 8, 2020 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Drexel University Current Accepting new patients
Drexel University CurrentSince Jul 1, 2014 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Oct 1, 2021 Accepting new patients
Wellspan Medical Group CurrentSince Jun 8, 2020 Accepting new patients
Drexel University CurrentSince Jul 1, 2014 Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

140 N Pointe Blvd
Lancaster, PA 17601
Phone (717) 291-0700

2813 Cottman Ave
Philadelphia, PA 19149
Phone (215) 332-9666

1427 Vine St
Fl 2
Philadelphia, PA 19102
Phone (215) 762-2530

219 N Broad St
Fl 2
Philadelphia, PA 19107
Phone (215) 762-5030

1601 Cherry St
Ste 11511
Philadelphia, PA 19102

219 N Broad St
Fl 9
Philadelphia, PA 19107
Phone (215) 762-2688

1427 Vine St
Fl 8
Philadelphia, PA 19102
Phone (215) 762-6660

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

Organizations & group practices 10

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.

Hospital & facility affiliations 33

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1811945017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST",
            "address_2": "SUITE 11511",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021321",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N BROAD ST",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071519",
            "telephone_number": "215-762-5080",
            "fax_number": "215-561-8071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTAINE",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD042292L",
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "PA",
            "license": "MD042292L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001214146",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.