NPIMap

Individual provider Active NPI

Daniel G. Fontanez, MD

  • Diagnostic Radiology Physician
  • Metairie, LA
National Provider Identifier
1821093717
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
023086 Issued in LA
Practice address
4200 Houma Blvd
Metairie, LA 70006-2970
Phone
(504) 454-4133
Fax
(504) 456-8125
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 023086 LA Primary

Addresses

Primary practice location

4200 Houma Blvd
Metairie, LA 70006-2970

Mailing address

PO Box 8090
Metairie, LA 70011-8090
Phone (504) 454-4133

Other identifiers 1

IdentifierTypeStateIssuer
1499579MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20060417000079 LA Practitioner - Diagnostic Radiology 2365451598 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Ponce School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Imaging ServicesGroup PAC ID 7618872102, 22 clinicians

Practice addresses (Care Compare)

1415 Tulane Ave
New Orleans, LA 70112-2600

4241 Veterans Blvd
Suite 100
Metairie, LA 70006-5430
Phone (504) 888-7921

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023086LAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Nov 4, 2024 Accepting new patients
Administrators of the Tulane Educational Fund Current Accepting new patients
Administrators of the Tulane Education Fund CurrentSince Nov 4, 2024 Accepting new patients
Radiology & Interventional Associates of Metairie LLC Diagnostic Radiology CurrentSince Aug 1, 2010 Accepting new patients
Diagnostic Imaging Services CurrentSince Oct 1, 2024 Accepting new patients
Tulane University Medical Group Past Accepting new patients

Locations

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

71154 Highway 21
Covington, LA 70433
Phone (985) 463-5476

925 Avenue C
Marrero, LA 70072
Phone (504) 459-3200

4700 S I 10 Svc Rd W
Metairie, LA 70001
Phone (504) 780-6453

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

1415 Tulane Ave
Fl 2
New Orleans, LA 70112
Phone (504) 988-1200

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCFJBA

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1821093717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8090",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700118090",
            "telephone_number": "504-454-4133",
            "fax_number": "504-456-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062970",
            "telephone_number": "504-454-4133",
            "fax_number": "504-456-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANEZ",
        "first_name": "DANIEL",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "023086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1499579",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.