Individual provider Active NPI

Alexis Maguin Fenton, MD

  • Clinical Cardiac Electrophysiology Physician
  • Lexington, KY
National Provider Identifier
1891802880
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
TP339 Issued in KY
Practice address
800 Rose St
Lexington, KY 40536-4552
Phone
(859) 323-0295
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X TP339 KY
Cardiovascular Disease Physician 207RC0000X L1571 TX
Clinical Cardiac Electrophysiology Physician 207RC0001X L1571 TX
Clinical Cardiac Electrophysiology Physician 207RC0001X MD2018-0640 NM
Clinical Cardiac Electrophysiology Physician 207RC0001X TP339 KY Primary

Addresses

Primary practice location

800 Rose St
Lexington, KY 40536-4552

Mailing address

1150 N Loop 1604 W # 108-645
San Antonio, TX 78248-4552
Phone (210) 332-3524

Other practice location 1

1150 N Loop 1604 W # 108-645
San Antonio, TX 78248-4552
Phone (210) 332-3524

Other identifiers 1

IdentifierTypeStateIssuer
141194406MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040601000970 TX Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 1456333871

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Texas Medical Branch at Galveston, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18620 NW 47TH Ave
Miami Gardens, FL 33055-2502

6101 Blue Lagoon Dr
Suite 200
Miami, FL 33126

Merit-based Incentive Payment System (MIPS)

Final score
84.46 of 100Reported as group
Quality
71.92
Promoting interoperability
99
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2018-0640NMMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Regional Medical Center Inc Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 6956-fenton-alexis@direct.leadingreach.com

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1891802880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N LOOP 1604 W # 108-645",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782484552",
            "telephone_number": "210-332-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405364552",
            "telephone_number": "859-323-0295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 N Loop 1604 W # 108-645",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782484552",
            "country_code": "US",
            "telephone_number": "210-332-3524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENTON",
        "first_name": "ALEXIS",
        "middle_name": "MAGUIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "TP339",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "L1571",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TX",
            "license": "L1571",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NM",
            "license": "MD2018-0640",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "KY",
            "license": "TP339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141194406",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.