Individual provider Active NPI

Nancy C. Fontana, AU.D.

  • Audiologist
  • Port Jefferson, NY
National Provider Identifier
1861652109
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1649 Issued in NY
Practice address
1500 Route 112
BLDG #4, 2ND Floor
Port Jefferson, NY 11776
Phone
(631) 928-0188
NPI assigned
Jun 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1649 NY Primary

Addresses

Primary practice location

1500 Route 112
BLDG #4, 2ND Floor
Port Jefferson, NY 11776

Mailing address

660 White Plains Road - Enta
Fourth Floor
Tarrytown, NY 10591-6802
Phone (914) 984-2552

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080922000433 NY Practitioner - Qualified Audiologist 2466529128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates LLPGroup PAC ID 0749193662, 431 clinicians

Practice addresses (Care Compare)

1500 Route 112
BLDG 4
Port Jefferson Station, NY 11776-8055
Phone (631) 928-0188

Merit-based Incentive Payment System (MIPS)

Final score
94.45 of 100Reported as group
Quality
89.91
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001649NYMDMental Health Counselor
1649NYMDAudiologist

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 1

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": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1861652109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 WHITE PLAINS ROAD - ENTA",
            "address_2": "FOURTH FLOOR",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105916802",
            "telephone_number": "914-984-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 112",
            "address_2": "BLDG #4, 2ND FLOOR",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "11776",
            "telephone_number": "631-928-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANA",
        "first_name": "NANCY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "1649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.