JOHN FRONTERA MD
NPI 1194796268
Psychiatry & Neurology - Neurology in Gainesville, GA

NPI Status: Active since January 27, 2006

Contact Information

1315 JESSE JEWELL PARKWAY
GAINESVILLE, GA
ZIP 30501
Phone: (770) 219-6520
Fax: (770) 219-6521

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  • Individual
  • Male
  • Psychiatry & Neurology
  • Neurology
  • PECOS Enrolled

About JOHN FRONTERA

This page provides the complete NPI Profile along with additional information for John Frontera, a provider established in Gainesville, Georgia with a medical specialization in Psychiatry & Neurology, focusing in neurology . The healthcare provider is registered in the NPI registry with number 1194796268 assigned on January 2006. The practitioner's primary taxonomy code is 2084N0400X with license number MD070263L (PA). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1194796268
Provider Name
JOHN FRONTERA MD
Gender
Male
Entity Type
Individual
Location Address
1315 JESSE JEWELL PARKWAY GAINESVILLE, GA 30501
Location Phone
(770) 219-6520
Location Fax
(770) 219-6521
Mailing Address
PO BOX 742616 ATLANTA, GA 30374
Mailing Phone
(770) 219-8420
Is Sole Proprietor?
No
Enumeration Date
01-27-2006
Last Update Date
01-29-2021
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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

Psychiatry & Neurology Neurology

Taxonomy Code
2084N0400X
Type
Allopathic & Osteopathic Physicians
License No.
MD070263L
License State
PA
Taxonomy Description
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
0018031450005MEDICAID (05)PA 
443534OTHER (01)PAHIGHMARK BS
5686065OTHER (01)FIRST HEALTH
000830541BMEDICAID (05)GA 
58052OTHER (01)PAGEISINGER
50057449OTHER (01)PAKEYSTONE CAPITAL BC
20048652OTHER (01)PAAMERIHEALTH MERCY
820123OTHER (01)PAFIRST PRIORITY HEALTH
0018031450003MEDICAID (05)PA 

Medicare Participation & PECOS Enrollment Status

John Frontera 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

  • 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

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 176 times for 148 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 115 times for 97 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 15 times for 15 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 14 times for 14 patients

Needle measurement of electrical activity in arm or leg muscles, complete study

This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.

This service was performed 22 times for 14 patients

Needle measurement of electrical activity in arm or leg muscles, limited study

This procedure, known as an electromyography (EMG), involves placing tiny needles into your arm or leg muscles to measure their electrical activity. It's a limited study, meaning only specific muscles are tested. This helps identify any muscle or nerve dysfunction.

This service was performed 27 times for 17 patients

Nerve conduction, 5-6 studies

Nerve conduction studies involve testing the speed and strength of signals traveling through your nerves. This helps identify any nerve damage or dysfunction. For 5-6 studies, this means multiple nerves will be tested. Small electrodes are placed on your skin to send and receive signals, causing minimal discomfort.

This service was performed 14 times for 14 patients

Nerve conduction, 9-10 studies

Nerve conduction studies involve sending small electrical shocks through the skin to measure how quickly nerves transmit signals. This helps detect nerve damage. 9-10 studies mean this process will be repeated on different nerves to gather comprehensive data.

This service was performed 21 times for 21 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 70 times for 70 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 31 times for 31 patients

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 30501 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $124.1
  • Minimum New Patient Price $53.31
  • Maximum New Patient Price $164.04
  • Average New Patient Copayment $31.02
  • Minimum New Patient Copayment $13.32
  • Maximum New Patient Copayment $41.01

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $94.84
  • Minimum Established Patient Price $16.68
  • Maximum Established Patient Price $133.24
  • Average Established Patient Copayment $23.71
  • Minimum Established Patient Copayment $4.17
  • Maximum Established Patient Copayment $33.31

* 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.

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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 1194796268, we treat the final digit (8) 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 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

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.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
4
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
9
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
2
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
8
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 9 → 18 → 9 7 → 14 → 5 6 → 12 → 3 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 8 + 4 + 1 + 4 + 9 + 1 + 2 + 2 + 1 + 2 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1194796268.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Physician Assistant
1315 JESSE JEWELL PARKWAY
GAINESVILLE, GA 30501
Obstetrics & Gynecology
1315 JESSE JEWELL PARKWAY, SUITE 200
GAINESVILLE, GA 30501

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194796268, enumerated as an "individual" on January 27, 2006.

The provider is located at 1315 JESSE JEWELL PARKWAY GAINESVILLE, GA 30501 and the phone number is (770) 219-6520.

Psychiatry & Neurology with taxonomy code 2084N0400X and a focus in Neurology.

The provider might be accepting Accepts: Medicare, Medicaid, Highmark Blue Shield and. Please consult your insurance carrier or call the provider to verify.