PAUL FENTON MD
NPI 1194176586
Dermatology in Cedar Rapids, IA

Active since June 27, 2016PECOS EnrolledAccepts Medicare Assignment
83.31/100
CMS Quality Rating
202 10TH ST SE STE 270, CEDAR RAPIDS, IA 52403(319) 294-4319(319) 294-4298 Get Directions Write a Review

NPPES record last updated: June 29, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 16, 2021, Feb 16, 2021, Jun 18, 2020 and 2 more (5 updates tracked since 2016).

About Paul Fenton Md NPPES

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

PAUL FENTON MD (NPI 1194176586) is an individual dermatology provider in Cedar Rapids, Iowa, licensed in Iowa (MD-46284) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS, is affiliated with St Lukes Hospital, and maintains a secondary practice location in Marion.

NPPES Registry Identity

NPI1194176586
Entity TypeIndividualMale
Primary Taxonomy207N00000X
Provider Legal NamePAUL FENTONCredential: MD
Location Address202 10TH ST SE STE 270Cedar Rapids, IA 52403-2420
Mailing Address801 York StManitowoc, WI 54220-4630 · (920) 663-9008 · Fax (920) 684-1439
Fax(319) 294-4298
Sole ProprietorNo
Medical School CMSUniversity Of Iowa, Rj & L Carver College Of MedicineGraduated 2016
Enumeration DateJune 27, 2016
Last NPPES UpdateJune 29, 20225 updates tracked since enumeration
NPPES CertifiedJune 29, 2022
NPI 1194176586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in IA · MD-46284
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
202 10TH ST SE STE 270, Cedar Rapids, IA 52403

Secondary Practice Location 1

Location 12590 6th Ave Ste 103Marion, IA 52302-4339 · Phone (319) 249-6422 · Fax (319) 249-6822

Accepted Insurance

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

Paul Fenton Md 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 ID8921391103
PECOS Enrollment IDI20200622000354
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.

Areas of Expertise CMS Part B claims 20

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
684 services185 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
640 services534 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
298 services262 patients
Destruction of skin growth, 1-14 growths 17110
"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.
210 services194 patients
Biopsy of related skin growth, first growth 11102
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
168 services154 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
145 services145 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Lukes Hospital

Acute Care Hospitals · Cedar Rapids, IA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number160045
Location1026 A Ave NECedar Rapids, IA 52402 · Linn County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 52403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.84 typical visit price
range $52.96 – $161.40
Typical copayment $20.46 (range $13.24 – $40.35)
Most-billed visit code 99203
Established Patient
$66.36 typical visit price
range $16.91 – $131.98
Typical copayment $16.59 (range $4.22 – $32.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.38
Promoting Interoperability99
Improvement Activities40
Cost65.82

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dermatology
202 10TH ST SE STE 270
CEDAR RAPIDS, IA 52403
Dermatology
202 10TH ST SE STE 270
CEDAR RAPIDS, IA 52403
Physician Assistant
202 10TH ST SE STE 270
CEDAR RAPIDS, IA 52403
Physician Assistant
202 10TH ST SE STE 270
CEDAR RAPIDS, IA 52403
Dermatology
202 10TH ST SE STE 270
CEDAR RAPIDS, IA 52403
Dermatology
202 10TH ST SE STE 270, C/O PCI MEDICAL PAVILLION
CEDAR RAPIDS, IA 52403

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 Paul Fenton's NPI number?

The NPI number for Paul Fenton is 1194176586. It was assigned to this individual provider in the NPPES registry on June 27, 2016.

Where is Paul Fenton located?

Paul Fenton practices at 202 10th St SE Ste 270, Cedar Rapids, IA 52403. The listed phone number is (319) 294-4319.

What is Paul Fenton's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Paul Fenton enrolled in Medicare?

Yes. Paul Fenton 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.

What insurance does Paul Fenton accept?

Health plans from Medica, Oscar Health Maintenance Organization of Florida and Oscar Insurance Company list Paul Fenton as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Paul Fenton affiliated with any hospitals?

According to CMS data, Paul Fenton is affiliated with St Lukes Hospital.

When was this NPI record last updated?

The NPPES record for Paul Fenton was last updated on June 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.