Lucia Fernanda Fontalvo-Herazo, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

LT000622 Issued in PA

Practice address

34TH Street and Civic Center Blvd
Philadelphia, PA 19104-6503

Phone

(215) 590-2575

Fax

(215) 590-5797

NPI assigned

May 21, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Radiology Associates of Children's Hospital, Inc

  dba Rach

  • Pediatric Radiology Physician
  • Philadelphia, PA
  • NPI 1467403261

  Diagnostic Radiology

  NPD (past)

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841408879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452304",
            "telephone_number": "215-590-2575",
            "fax_number": "215-590-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34TH STREET AND CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191046503",
            "telephone_number": "215-590-2575",
            "fax_number": "215-590-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTALVO-HERAZO",
        "first_name": "LUCIA",
        "middle_name": "FERNANDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "LT000622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roger A Fons, MD
• Allison Ryan Font, MD
• Zuleika C Font, M.D.
• Jean H Fontaine, D.C.
• John Fontaine, MD
• Nicole Michele Fontana, RD
• John R Fontanilla, M.D.
• Sarah Rose Fonte, LCSW
• Ateh Fonteh, MD
• Anna Budd Fontenot, CRNP

• Diagnostic Radiology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Diagnostic Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.