DR. JOHN R FONTANILLA


Address: 4453 Castor Ave, Suite B, Philadelphia, PA 19124-3846
Phone: 2157442266

DR. JOHN R FONTANILLA (NPI# 1669688412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1669688412
Entity Type Individual
Full Name DR. JOHN R FONTANILLA
Credential M.D.
Practice Address 4453 Castor Ave
Suite B
Philadelphia
PA 19124-3846
Practice Telephone 2157442266
Practice Fax Number 2157439247
Mailing Telephone 2157442266
Mailing Fax Number 2157439247
Enumeration Date 2007-05-15
Last Update Date 2012-07-27
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207R00000X Internal Medicine MT188798 PA Allopathic & Osteopathic Physicians
Y 207RN0300X Internal Medicine
Specialization: Nephrology
MD445193 PA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
PA TPI MEDICARE GROUP 597586 01
PA TPI RAILROAD MEDICARE GROUP ID CD4829 01
PA TPI MEDICAID GROUP 1007278000113 01

Office Location

Street Address 4453 CASTOR AVE
SUITE B
City PHILADELPHIA
State PA
Zip Code 19124-3846

Providers in the same location

NPI Name Taxonomy Address Enumeration
1407817745 Theodora K. Bernardini Internal Medicine 4453 Castor Ave, Suite B, Philadelphia, PA 19124-3846 2006-03-28
1992018378 Nicola Stepanian Internal Medicine 4453 Castor Ave, Ste B, Philadelphia, PA 19124-3846 2010-07-14
1972821064 Analiza P Guerrero Registered Nurse 4453 Castor Ave, Suite B, Philadelphia, PA 19124-3846 2010-05-13
1790993988 Justin Vadaparampil Internal Medicine 4453 Castor Ave, Suite B, Philadelphia, PA 19124-3846 2007-05-19
1093819864 Bio-medical Applications of Pennsylvania, Inc Clinic/Center 4453 Castor Ave, Philadelphia, PA 19124-3846 2006-09-12
1801836705 Kelly D Heiland Internal Medicine 4453 Castor Ave, Suite B, Philadelphia, PA 19124-3846 2006-06-08
1417900630 Metropolitan Nephrology Associates, P.C. Internal Medicine 4453 Castor Ave, Suite B, Philadelphia, PA 19124-3846 2006-05-18
1811958564 Kenneth A. Knowles Internal Medicine 4453 Castor Ave, Suite B, Philadelphia, PA 19124-3846 2006-03-31
1578524526 Michael L. Levin Internal Medicine 4453 Castor Ave, Suite B, Philadelphia, PA 19124-3846 2006-03-30
1497737746 William A. Nickey Internal Medicine 4453 Castor Ave, Suite B, Philadelphia, PA 19124-3846 2005-11-14
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1831749308 William Mark Hanna Sr. Pharmacist 4600 Rooselvelt Blvd Bldg G, Philadelphia, PA 19124 2019-09-17
1881256451 Medical Discovery Systems, LLC Durable Medical Equipment & Medical Supplies 5425 Oxford Ave., 5425 Oxford Ave. Suite (3 A), Philadelphia, PA 19124 2019-07-03
1548731391 Sierra Pinkney Registered Nurse 1615 Granite St, Philadelphia, PA 19124 2018-12-05
1922507987 Xavier Sergio Henriquez Counselor 4510 Frankford Avenue 2nd Floor, Philadelphia, PA 19124 2018-02-06
1558881581 Isabel Cristina Castillo Hernandez Pediatrics 4500-10, Apt 201b, Philadelphia, PA 19124 2017-06-21
1952843732 Patrick Grugan Social Worker Roosevelt Boulevard & Adams Avenue, Philadelphia, PA 19124 2016-11-10
1811340482 Katarzyna Liwski Psychiatry & Neurology 4641 Roosevelt Boulevard, E212, Drexel University College of Medicine Friends Hospital, Philadelphia, PA 19124 2016-07-19
1851769327 Aleka Kostouros Social Worker Roosevelt Blvd & Adams Ave, Northeast Community Center for Behavioral Health, Philadelphia, PA 19124 2015-09-14
1407230378 Sara Bachani Psychiatry & Neurology 4641 Roosevelt Blvd, Friends Hospital, Room 231, Philadelphia, PA 19124 2015-07-10
1215327051 Alyssa Renee Kirk Counselor 4500-10 Frankford Ave, 2nd Floor, Philadelphia, PA 19124 2015-02-02
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Taxonomy Information

Taxonomy Code 207RN0300X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Nephrology

Taxonomy Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1578124038 Ali Arif Internal Medicine 245 N 15th St Ste 6144, Philadelphia, PA 19102-1101 2019-06-25
1710344171 Nina Stuccio Internal Medicine 410 S Front St Unit 215, Philadelphia, PA 19147-1708 2016-01-15
1497068613 Anupama Nair Internal Medicine 1324 Locust St, Apt 205 The Arts Condominium, Philadelphia, PA 19107 2010-07-16
1972739621 Mortimer M Civan Internal Medicine A303 Richards Building, 3700 Hamilton Walk, Dept. of Physiology, Univ. of Pennsylvania, Philadelphia, PA 19104-6085 2009-06-09
1790795391 Arthur Robert Olshan Internal Medicine 205 N Broad St Ste 600, Philadelphia, PA 19107-1555 2006-08-08
1407817745 Theodora K. Bernardini Internal Medicine 4453 Castor Ave, Suite B, Philadelphia, PA 19124-3846 2006-03-28
1902874670 Eric J Bloom Internal Medicine 5501 Old York Road, Moss 4th Floor, Sley Building, Einstein Nephrology Associates, Philadelphia, PA 19141 2006-03-09
1821071473 Edward R. Jones Internal Medicine 10 E Moreland Ave, Suite 100, Philadelphia, PA 19118-3541 2005-11-28
1366425092 Peter Fumo Internal Medicine 10 E Moreland Ave Ste 100, Philadelphia, PA 19118-3562 2005-11-28
1790773547 Ellie Kelepouris Internal Medicine 216 N. Broad St., 5th Floor, Philadelphia, PA 19102 2005-10-06
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Competitor

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City PHILADELPHIA
Zip Code 19124

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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