Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ALEXANDRA FONTANILLA NP
NPI 1710536628
Nurse Practitioner - Pediatrics in Santa Rosa, CA

Q: What is Alexandra Fontanilla's NPI number?

The NPI number for Alexandra Fontanilla is 1710536628. It was assigned to this individual provider in the NPPES registry on September 4, 2019.

Q: What is Alexandra Fontanilla's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Active since September 04, 2019PECOS Enrolled

711 STONY POINT RD STE 17, SANTA ROSA, CA 95407(707) 303-3600 Get Directions Write a Review

NPPES record last updated: July 14, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jul 14, 2026, Apr 25, 2026, Sep 4, 2019 (3 updates tracked since 2019).

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About Alexandra Fontanilla Np NPPES

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

ALEXANDRA FONTANILLA NP (NPI 1710536628) is an individual pediatrics provider in Santa Rosa, California, licensed in California (95038145) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710536628

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameALEXANDRA FONTANILLACredential: NP

Location Address711 STONY POINT RD STE 17Santa Rosa, CA 95407-6848

Mailing Address711 Stony Point Rd Ste 17Santa Rosa, CA 95407-6848

Phone(707) 303-3600

Sole ProprietorNo

Enumeration DateSeptember 4, 2019

Last NPPES UpdateJuly 14, 20263 updates tracked since enumeration

NPPES CertifiedJuly 14, 2026

✔ NPI 1710536628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in CA · 95038145

711 STONY POINT RD STE 17, Santa Rosa, CA 95407

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alexandra Fontanilla Np 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95407 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

$96.16 typical visit price

range $63.04 – $187.01

Typical copayment $24.04 (range $15.76 – $46.75)

Most-billed visit code 99203

Established Patient

$109.88 typical visit price

range $21.02 – $153.40

Typical copayment $27.47 (range $5.25 – $38.35)

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 6

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

MADISON NICHOLE YUNGERT

Pediatrics