Paul W Fonken, M.D.

Key facts

NPI

1831153345

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

28920 (CO)

Practice address

131 Stanley Ave
Suite 202
Estes Park, CO 80517-6363

Phone

(970) 586-2343

Fax

(970) 586-9060

NPI assigned

Apr 12, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 5

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.

• Uchealth Estes Valley Medical Center Critical Access Hospital · Estes Park, CO · NPI 1154312981
  Medicare reassignment NPD CO
• Rural Physicians Group-Pannu PLLC Hospitalist Physician · Greenwood Village, CO · NPI 1891236584
  Medicare reassignment CO
• Rural Physicians Group - Pannu PLLC Hospitalist Physician · Delta, CO · NPI 1851972087
  NPD FAMILY MEDICINE
• Uchealth Estes Valley Medical Center Primary Care Clinic/Center · Estes Park, CO · NPI 1467581470
  NPD FAMILY MEDICINE
• S Pannu Inc Internal Medicine Physician · Susanville, CA · NPI 1407987522
  NPD (past)

Hospital & facility affiliations 1

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

• Uchealth Estes Valley Medical Center Critical Access Hospital · Estes Park, CO · NPI 1154312981
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Family Practice

Education

University of New Mexico School of Medicine, 1987

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Estes Park Medical Center Hospital · Estes Park, CO · CCN 061312

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pfonken@yourcarecommunity.org

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 3, 2017.

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1831153345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 STANLEY AVE",
            "address_2": "SUITE 202",
            "city": "ESTES PARK",
            "state": "CO",
            "postal_code": "805176363",
            "telephone_number": "970-586-2343",
            "fax_number": "970-586-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 STANLEY AVE",
            "address_2": "SUITE 202",
            "city": "ESTES PARK",
            "state": "CO",
            "postal_code": "805176363",
            "telephone_number": "970-586-2343",
            "fax_number": "970-586-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONKEN",
        "first_name": "PAUL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "28920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01289206",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Estes Park, CO · Family Medicine Physician in Colorado