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JOHN WILLIAM FANTA
NPI 1215517438
Psychiatry & Neurology - Neurology in Indianapolis, IN

Active since April 12, 2021PECOS EnrolledAccepts Medicare Assignment
1120 W MICHIGAN ST # CL642, INDIANAPOLIS, IN 46202(317) 278-2686 Get Directions Write a Review

NPPES record last updated: July 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About John William Fanta NPPES

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

JOHN WILLIAM FANTA (NPI 1215517438) is an individual neurology provider in Indianapolis, Indiana, licensed in Michigan (4301513777) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, is affiliated with Munson Healthcare Cadillac Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1215517438
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameJOHN WILLIAM FANTA
Location Address1120 W MICHIGAN ST # CL642Indianapolis, IN 46202-5209
Mailing Address1120 W Michigan St # Cl642Indianapolis, IN 46202-5209 · (317) 278-2686
Phone(317) 278-2686
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateApril 12, 2021
Last NPPES UpdateJuly 30, 2025
NPPES CertifiedJuly 30, 2025
✔ NPI 1215517438 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 MI · 4301513777
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.
1120 W MICHIGAN ST # CL642, Indianapolis, IN 46202
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11345 E Parkdale AveManistee, MI 49660-9318 · Phone (231) 398-1750
Location 23922 Cedar Run RdTraverse City, MI 49684-9687 · Phone (231) 392-0430

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community.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

John William Fanta 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 ID5890196331
PECOS Enrollment IDI20250819000930
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.

Hospital Affiliations CMS Care Compare 5

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

Munson Healthcare Cadillac Hospital

Acute Care Hospitals · Cadillac, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230081
Location400 Hobart StCadillac, MI 49601 · Wexford County
Emergency services Birthing friendly

Munson Medical Center

Acute Care Hospitals · Traverse City, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230097
Location1105 Sixth StreetTraverse City, MI 49684 · Grand Traverse County
Emergency services Birthing friendly

Mclaren Northern Michigan

Acute Care Hospitals · Petoskey, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230105
Location416 Connable AvePetoskey, MI 49770 · Emmet County
Emergency services Birthing friendly

Munson Healthcare Otsego Memorial Hospital

Acute Care Hospitals · Gaylord, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230133
Location825 N Center AveGaylord, MI 49735 · Otsego County
Birthing friendly

Munson Healthcare Manistee Hospital

Acute Care Hospitals · Manistee, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230303
Location1465 E Parkdale AveManistee, MI 49660 · Manistee County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46202 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
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

MARTHA ANNA CANCILLA MD
Hospitalist
1120 W MICHIGAN ST # CL642
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686
DR. DESTINY J HAUSE MD
Student in an Organized Health Care Education/Training Program
1120 W MICHIGAN ST # CL642
INDIANAPOLIS, IN 46202
Marion County (404) 822-4779
RACHEL G SUSLER MD
Student in an Organized Health Care Education/Training Program
1120 W MICHIGAN ST # CL642
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686
SARAH RENE YATES DO
Student in an Organized Health Care Education/Training Program
1120 W MICHIGAN ST # CL642
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686
JASON EDWARD KIPPENBROCK MD
Internal Medicine
1120 W MICHIGAN ST # CL642
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686
JACK TIAHNYBIK DO
Student in an Organized Health Care Education/Training Program
1120 W MICHIGAN ST # CL642
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686
ANDREW O'NEIL MD
Anesthesiology
1120 W MICHIGAN ST # CL642
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686
MARIE CLARK
Student in an Organized Health Care Education/Training Program
1120 W MICHIGAN ST # CL642
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686

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 John Fanta's NPI number?

The NPI number for John Fanta is 1215517438. It was assigned to this individual provider in the NPPES registry on April 12, 2021.

Where is John Fanta located?

John Fanta practices at 1120 W Michigan St # Cl642, Indianapolis, IN 46202. The listed phone number is (317) 278-2686.

What is John Fanta's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is John Fanta enrolled in Medicare?

Yes. John Fanta 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 John Fanta accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and McLaren Health Plan Community list John Fanta 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 John Fanta affiliated with any hospitals?

According to CMS data, John Fanta is affiliated with Munson Healthcare Cadillac Hospital, Munson Medical Center, Mclaren Northern Michigan, Munson Healthcare Otsego Memorial Hospital and Munson Healthcare Manistee Hospital.

When was this NPI record last updated?

The NPPES record for John Fanta was last updated on July 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.