Active NPI
Melissa C Fontenot, PA
- Physician Assistant
- Tallahassee, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9104437
- Practice address
- 3334 Capital Medical Blvd
400
Tallahassee, FL 32308-8405 - Phone
- (850) 877-8174
- Fax
- (844) 261-6839
- NPI assigned
- Nov 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9104437 | FL | Primary |
Addresses
Primary practice location
3334 Capital Medical Blvd
400
Tallahassee, FL 32308-8405
Mailing address
3334 Capital Medical Blvd. #400
Tallahassee, FL 32308-4470
Phone (850) 877-8174
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 024969200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 76.5 of 100
- Quality
- 47.27
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 75.24
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007188 | GA | MD | Pediatric Rehabilitation Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tallahassee Orthopedic Clinic III PL | Current | Accepting new patients | |
| Tallahassee Orthopedic Clinic III, P.L. | Current | Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients | |
| The University of Texas Health Science Center at San Antonio | Past | Accepting new patients |
Locations
2011 Harrison Ave
Panama City, FL 32405
Phone (850) 691-4188
803 W Main St
Perry, FL 32347
Phone (850) 584-7078
1401 Centerville Rd
Ste 300
Tallahassee, FL 32308
Phone (850) 877-5115
3334 Capital Medical Blvd
Ste 400
Tallahassee, FL 32308
3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 210-1808
603 Wheat Ave
Ste 800
Bainbridge, GA 39819
Phone (229) 246-3608
603 Wheat Ave
Bainbridge, GA 39819
Phone (229) 246-1209
Organizations & group practices 4
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.
-
- Medical Specialty Clinic/Center
- Tallahassee, FL
- NPI 1194778050
-
- Durable Medical Equipment & Medical Supplies
- Panama City Beach, FL
- NPI 1497617948
-
- Multi-Specialty Clinic/Center
- Bainbridge, GA
- NPI 1053388256
-
- General Acute Care Hospital
- San Antonio, TX
- NPI 1326829904
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581465600000",
"number": "1982777264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3334 CAPITAL MEDICAL BLVD. #400",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323084470",
"telephone_number": "850-877-8174",
"fax_number": "844-261-6839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3334 CAPITAL MEDICAL BLVD",
"address_2": "400",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323088405",
"telephone_number": "850-877-8174",
"fax_number": "844-261-6839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTENOT",
"first_name": "MELISSA",
"middle_name": "C",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-16",
"last_updated": "2020-02-12",
"certification_date": "2020-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9104437",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "024969200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.