PHILIP JOSEPH FONSECA
NPI 1164124376
Student in an Organized Health Care Education/Training Program in Los Angeles, CA
About Philip Joseph Fonseca NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PHILIP JOSEPH FONSECA (NPI 1164124376) is an individual student in an organized health care education/training program in Los Angeles, California and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Philip Joseph Fonseca is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Philip Fonseca reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Los Angeles, CA 90027
- Reassigned Medicare billing, California enrollment
- 13,921 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
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 Philip Fonseca's NPI number?
The NPI number for Philip Fonseca is 1164124376. It was assigned to this individual provider in the NPPES registry on March 21, 2023.
Where is Philip Fonseca located?
Philip Fonseca practices at 4733 W Sunset Blvd Fl 3, Los Angeles, CA 90027. The listed phone number is (323) 783-6399.
What is Philip Fonseca's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Philip Fonseca enrolled in Medicare?
Yes. Philip Fonseca is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Philip Fonseca's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Philip Fonseca reassigns Medicare benefits to Southern California Permanente Medical Group (Los Angeles, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Philip Fonseca's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Philip Fonseca was last updated on June 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Philip Joseph Fonseca · NPI 1164124376
Student in an Organized Health Care Education/Training Program provider in Los Angeles, California. Individual provider, active in the CMS NPPES registry since March 21, 2023.
## Identity
- **NPI:** 1164124376 (Entity type: Individual)
- **Enumerated:** March 21, 2023
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 4733 W SUNSET BLVD FL 3, Los Angeles, CA 90027-6021
- **Phone:** (323) 783-6399
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1134151657, Los Angeles, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** June 28, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1164124376) · Data from the CMS NPPES public registry.