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ANDREW LAZARO FONTICIELLA PA STUDENT
NPI 1023814001
Student in an Organized Health Care Education/Training Program in San Lorenzo, CA

Active since February 20, 2025PECOS EnrolledAccepts Medicare Assignment
16037 VIA DEL SOL, SAN LORENZO, CA 94580(818) 935-7076 Get Directions Write a Review

NPPES record last updated: April 10, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Apr 10, 2026, Feb 20, 2025 (2 updates tracked since 2025).

About Andrew Lazaro Fonticiella Pa Student NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREW LAZARO FONTICIELLA PA STUDENT (NPI 1023814001) is an individual student in an organized health care education/training program in San Lorenzo, California and active in the NPI registry since February 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1023814001
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameANDREW LAZARO FONTICIELLACredential: PA STUDENT
Location Address16037 VIA DEL SOLSan Lorenzo, CA 94580-2407
Mailing Address16037 Via Del SolSan Lorenzo, CA 94580-2407 · (818) 935-7076
Phone(818) 935-7076
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateFebruary 20, 2025
Last NPPES UpdateApril 10, 20262 updates tracked since enumeration
NPPES CertifiedApril 10, 2026
✔ NPI 1023814001 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA67745 (CA)
16037 VIA DEL SOL, San Lorenzo, CA 94580
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Andrew Lazaro Fonticiella Pa Student is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991272171
PECOS Enrollment IDI20260424001342
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andrew Fonticiella's NPI number?

The NPI number for Andrew Fonticiella is 1023814001. It was assigned to this individual provider in the NPPES registry on February 20, 2025.

Where is Andrew Fonticiella located?

Andrew Fonticiella practices at 16037 Via Del Sol, San Lorenzo, CA 94580. The listed phone number is (818) 935-7076.

What is Andrew Fonticiella's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Andrew Fonticiella enrolled in Medicare?

Yes. Andrew Fonticiella is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Andrew Fonticiella was last updated on April 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.