Individual provider Active NPI

Frederick Manalo Alcantara, M.D.

  • Family Medicine Physician
  • Fairmont, WV
National Provider Identifier
1942493812
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23746 Issued in WV
Practice address
2048 Vip Way
Fairmont, WV 26554
Phone
(304) 366-6200
Fax
(304) 366-4927
NPI assigned
Aug 23, 2007
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD432566 PA
Family Medicine Physician 207Q00000X 23746 WV Primary

Addresses

Primary practice location

2048 Vip Way
Fairmont, WV 26554

Mailing address

252 Hanalei Dr
Morgantown, WV 26508-4263
Phone (304) 594-0916

Other identifiers 3

IdentifierTypeStateIssuer
1020032650001MedicaidPA
P00434792OtherPAMEDICARE TRAVELERS
AL1983636OtherPABLUE SHIELD

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address falcantara28030@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address falcantara28030@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address falcantara28030@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20100210000683 WV Practitioner - Family PracticePractitioner - Emergency Medicine 3274621149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
United Hospital Center IncGroup PAC ID 8123936010, 290 clinicians

Practice addresses (Care Compare)

527 Medical Park Dr
Suite 500
Bridgeport, WV 26330-9010
Phone (681) 342-3625

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD432566PAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
United Hospital Center, Inc. Family Medicine CurrentSince Dec 14, 2020 Accepting new patients
United Hospital Center, Inc Past Accepting new patients
United Hospital Center Past Accepting new patients

Locations

327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000

527 Medical Park Dr
Ste 204
Bridgeport, WV 26330
Phone (304) 623-5711

527 Medical Park Dr
Ste 500
Bridgeport, WV 26330
Phone (681) 342-3600

916 W Main St
Bridgeport, WV 26330
Phone (304) 842-1034

2673 Davisson Run Rd
Ste 303
Clarksburg, WV 26301

200 Route 98 W St
Ste 107
Nutter Fort, WV 26301
Phone (304) 623-5711

Interoperability endpoints

  • Direct secure messaging: falcantara28030@direct.wvuhsdirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1942493812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 HANALEI DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265084263",
            "telephone_number": "304-594-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2048 VIP WAY",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "26554",
            "telephone_number": "304-366-6200",
            "fax_number": "304-366-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALCANTARA",
        "first_name": "FREDERICK",
        "middle_name": "MANALO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD432566",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "23746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020032650001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TRAVELERS",
            "identifier": "P00434792",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "AL1983636",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "falcantara28030@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6040 University Town Centre Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265012421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "falcantara28030@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "527 Medical Park Dr",
            "city": "Bridgeport",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263309008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "falcantara28030@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6040 University Town Centre Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265012421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

Verify at the official NPI Registry.