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ANDREW DANIEL FONTES D.O.
NPI 1174056758
Pediatrics - Pediatric Critical Care Medicine in Salt Lake City, UT

Active since April 10, 2017PECOS Enrolled
295 S CHIPETA WAY, SALT LAKE CITY, UT 84108(801) 587-7572 Get Directions Write a Review

NPPES record last updated: June 5, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 5, 2020, Apr 14, 2017 (2 updates tracked since 2017).

About Andrew Daniel Fontes D.o. NPPES

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

ANDREW DANIEL FONTES D.O. (NPI 1174056758) is an individual pediatric critical care medicine provider in Salt Lake City, Utah, licensed in Utah (11709353-1204) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174056758
Entity TypeIndividualMale
Primary Taxonomy2080P0203X
Provider Legal NameANDREW DANIEL FONTESCredential: D.O.
Location Address295 S CHIPETA WAYSalt Lake City, UT 84108-1287
Mailing Address295 S Chipeta WaySalt Lake City, UT 84108-1287 · (801) 587-7572
Phone(801) 587-7572
Sole ProprietorNo
Enumeration DateApril 10, 2017
Last NPPES UpdateJune 5, 20202 updates tracked since enumeration
NPPES CertifiedJune 5, 2020
✔ NPI 1174056758 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0203X
License✔ Licensed in UT · 11709353-1204
Definition
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
295 S CHIPETA WAY, Salt Lake City, UT 84108
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrew Daniel Fontes D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Andrew Fontes reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pediatric Anesthesia Associates Medical Group Inc
506 mi
Anesthesiology
9300 VALLEY CHILDRENS PL
Madera, CA 93636
  • Reassigned Medicare billing, California enrollment
  • 55 clinicians in this Medicare group
NPI 1558588871 (559) 353-3000

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.

KELLY STOUT PHD
Psychologist
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 213-3469
MALIA MONICA OLSON
Genetic Counselor, MS
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7400
ALEX NICOLE HESS NNP-BC
Nurse Practitioner (Neonatal)
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 558-8276
KATHRYN L. SONGER MD
Pediatrics (Pediatric Critical Care Medicine)
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7572
LAUREN MOLLY STERNBERG MD
Student in an Organized Health Care Education/Training Program
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 662-5700
RACHEL WILLIS
Nurse Practitioner (Neonatal)
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7400
DR. ERIN L. GOSEKAMP DO, MPH, MS
Pediatrics (Pediatric Critical Care Medicine)
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7572
GEORGE KHOURY
Student in an Organized Health Care Education/Training Program
295 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-7400

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 Fontes's NPI number?

The NPI number for Andrew Fontes is 1174056758. It was assigned to this individual provider in the NPPES registry on April 10, 2017.

Where is Andrew Fontes located?

Andrew Fontes practices at 295 S Chipeta Way, Salt Lake City, UT 84108. The listed phone number is (801) 587-7572.

What is Andrew Fontes's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Is Andrew Fontes enrolled in Medicare?

Yes. Andrew Fontes is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Andrew Fontes's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Fontes reassigns Medicare benefits to Pediatric Anesthesia Associates Medical Group Inc (Madera, 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 Andrew Fontes'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 Andrew Fontes was last updated on June 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.