DAVID M FANTLE MD
NPI 1205852613
Psychiatry & Neurology - Neurology in Salt Lake City, UT

Active since July 15, 2006PECOS Enrolled
400 C ST, SALT LAKE CITY, UT 84143(801) 408-8305 Get Directions Write a Review

NPPES record last updated: March 18, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About David M Fantle Md NPPES

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

DAVID M FANTLE MD (NPI 1205852613) is an individual neurology provider in Salt Lake City, Utah, licensed in Utah (3344141205) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205852613
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameDAVID M FANTLECredential: MD
Location Address400 C STSalt Lake City, UT 84143-1005
Mailing AddressPo Box 27128Salt Lake City, UT 84127-0128 · (801) 408-8305
Sole ProprietorYes
Enumeration DateJuly 15, 2006
Last NPPES UpdateMarch 18, 2008
NPI 1205852613 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License Licensed in UT · 3344141205
Definition

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.

400 C ST, Salt Lake City, UT 84143

Medicare Participation & PECOS Enrollment Status

David Fantle 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: Durable Medical Equipment (DME) 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: No

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: Yes

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 84143 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $125.7
  • Minimum New Patient Price $54.34
  • Maximum New Patient Price $166.03
  • Average New Patient Copayment $31.42
  • Minimum New Patient Copayment $13.58
  • Maximum New Patient Copayment $41.5

Established Patients Visit Costs *

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

  • Average Established Patient Price $96.35
  • Minimum Established Patient Price $17.23
  • Maximum Established Patient Price $135.2
  • Average Established Patient Copayment $24.08
  • Minimum Established Patient Copayment $4.3
  • Maximum Established Patient Copayment $33.8

* 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.

Reviews for DAVID M FANTLE MD

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Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Internal Medicine
400 C ST
SALT LAKE CITY, UT 84143
Nurse Practitioner
400 C ST
SALT LAKE CITY, UT 84143
Internal Medicine (Critical Care Medicine)
400 C ST
SALT LAKE CITY, UT 84143
Nurse Practitioner
400 C ST
SALT LAKE CITY, UT 84143
Internal Medicine (Critical Care Medicine)
400 C ST
SALT LAKE CITY, UT 84143
Genetic Counselor, MS
400 C ST
SALT LAKE CITY, UT 84143
Obstetrics & Gynecology (Maternal & Fetal Medicine)
400 C ST
SALT LAKE CITY, UT 84143
Internal Medicine (Critical Care Medicine)
400 C ST
SALT LAKE CITY, UT 84143
Nurse Practitioner
400 C ST
SALT LAKE CITY, UT 84143
Nurse Practitioner (Acute Care)
400 C ST
SALT LAKE CITY, UT 84143
Internal Medicine (Infectious Disease)
400 C ST
SALT LAKE CITY, UT 84143
Nurse Practitioner (Family)
400 C ST
SALT LAKE CITY, UT 84143
Nurse Practitioner
400 C ST
SALT LAKE CITY, UT 84143
Internal Medicine (Cardiovascular Disease)
400 C ST
SALT LAKE CITY, UT 84143
Nurse Practitioner
400 C ST
SALT LAKE CITY, UT 84143
Nurse Practitioner
400 C ST
SALT LAKE CITY, UT 84143
Anesthesiology
400 C ST
SALT LAKE CITY, UT 84143
Nurse Practitioner (Family)
400 C ST
SALT LAKE CITY, UT 84143
Anesthesiology
400 C ST
SALT LAKE CITY, UT 84143
Anesthesiology
400 C ST
SALT LAKE CITY, UT 84143

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1205852613, enumerated as an "individual" on July 15, 2006.

The provider is located at 400 C ST SALT LAKE CITY, UT 84143 and the phone number is (801) 408-8305.

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