DANIEL EDWARD FENTON II FNP-C
NPI 1093283863
Nurse Practitioner - Family in Grants, NM
NPI Status: Active since November 09, 2018
Contact Information
801 E ROOSEVELT AVE
GRANTS, NM
ZIP 87020
Phone: (505) 658-1347
Fax: (866) 422-1014
- Individual
- Male
- Nurse Practitioner
- Family
- PECOS Enrolled
- Opted-Out Medicare
- CLIA Number: 32D2277060
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-20-2027
About DANIEL FENTON
This page provides the complete NPI Profile along with additional information for Daniel Fenton, a provider established in Grants, New Mexico with a medical specialization in Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1093283863 assigned on November 2018. The practitioner's primary taxonomy code is 363LF0000X with license number RN-70242 (NM). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1093283863
- Provider Name
- DANIEL EDWARD FENTON II FNP-C
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 801 E ROOSEVELT AVE GRANTS, NM 87020
- Location Phone
- (505) 658-1347
- Location Fax
- (866) 422-1014
- Mailing Address
- 824 HOUSTON AVE GRANTS, NM 87020
- Mailing Phone
- (505) 315-1162
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-09-2018
- Last Update Date
- 10-11-2022
- Code Navigator
A nurse practitioner (NP) like Daniel Fenton is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Daniel Fenton opted out of Medicare effective on 04-01-2023 until 04-01-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- RN-70242
- License State
- NM
Medicare Participation & PECOS Enrollment Status
Daniel Fenton is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-01-2023
Opt-Out End Date: 04-01-2027
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Orthotic Devices
DME-Orthotic Devices (DF008N)
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each (HCPCS:A4351)
1 DME suppliers used 11 Medicare Claims 940 Services Paid
DME-Orthotic Devices (DF000N)
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each (HCPCS:A4358)
1 DME suppliers used 11 Medicare Claims 22 Services Paid
Durable Medical Equipment
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
2 DME suppliers used 79 Medicare Claims 83 Services Paid
DME-Other DME (DE001N)
Continuous positive airway pressure (cpap) device (HCPCS:E0601)
2 DME suppliers used 40 Medicare Claims 40 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
3 DME suppliers used 88 Medicare Claims 92 Services Paid
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 87020 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.79
- Minimum New Patient Price $54.26
- Maximum New Patient Price $166.8
- Average New Patient Copayment $21.19
- Minimum New Patient Copayment $13.56
- Maximum New Patient Copayment $41.7
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $96.38
- Minimum Established Patient Price $17
- Maximum Established Patient Price $135.35
- Average Established Patient Copayment $24.09
- Minimum Established Patient Copayment $4.25
- Maximum Established Patient Copayment $33.83
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 32D2277060
- Facility Type
- Physician Office
- Certificate Effective Date
- February 21, 2025
- Certificate Expiration Date
- February 20, 2027
- Laboratory Director
- DANIEL E. FENTON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Daniel Fenton to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1093283863, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1093283863, enumerated as an "individual" on November 09, 2018.
The provider is located at 801 E ROOSEVELT AVE GRANTS, NM 87020 and the phone number is (505) 658-1347.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
