PRINCEWILL FONTA PMHNP
NPI 1710612239
Nurse Practitioner - Psychiatric/Mental Health in Olympia, WA
About Princewill Fonta Pmhnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRINCEWILL FONTA PMHNP (NPI 1710612239) is an individual psychiatric/mental health provider in Olympia, Washington, licensed in Washington (AP70059722) and active in the NPI registry since July 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Princewill Fonta Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
6Medicare enrollment records show Princewill Fonta reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Quincy, MA 02169
- Reassigned Medicare billing, Massachusetts enrollment
- 101 clinicians in this Medicare group
Dartmouth, MA 02747
- Reassigned Medicare billing, Massachusetts enrollment
- 24 clinicians in this Medicare group
Dartmouth, MA 02747
- Reassigned Medicare billing, Massachusetts enrollment
- 7 clinicians in this Medicare group
N Dartmouth, MA 02747
- Reassigned Medicare billing, Massachusetts enrollment
- Medicare enrollment name: Olivier Group PC
- 4 clinicians in this Medicare group
New Bedford, MA 02745
- Reassigned Medicare billing, Massachusetts enrollment
New Bedford, MA 02740
- Reassigned Medicare billing, Massachusetts enrollment
- 99 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98506 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Princewill Fonta's NPI number?
The NPI number for Princewill Fonta is 1710612239. It was assigned to this individual provider in the NPPES registry on July 19, 2022.
Where is Princewill Fonta located?
Princewill Fonta practices at 711 State Ave NE, Olympia, WA 98506. The listed phone number is (360) 943-0780.
What is Princewill Fonta's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Princewill Fonta enrolled in Medicare?
Yes. Princewill Fonta is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Princewill Fonta's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Princewill Fonta reassigns Medicare benefits to 6 organizations: South Shore Mental Health Center, Inc. (Quincy, MA), Northeast Behavioral Health, LLC (Dartmouth, MA), Cornerstone Wellness Center PC (Dartmouth, MA), Olivier Group, P.C. (N Dartmouth, MA), Movement Wellness (New Bedford, MA) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Princewill Fonta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Princewill Fonta accept?
Health plans from Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list Princewill Fonta 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.
When was this NPI record last updated?
The NPPES record for Princewill Fonta was last updated on May 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Princewill Fonta, PMHNP · NPI 1710612239
Psychiatric/Mental Health physician in Olympia, Washington. Individual provider, active in the CMS NPPES registry since July 19, 2022.
## Identity
- **NPI:** 1710612239 (Entity type: Individual)
- **Enumerated:** July 19, 2022
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** AP70059722 (Washington)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 711 STATE AVE NE, Olympia, WA 98506-3984
- **Phone:** (360) 943-0780
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 6 organizations under Medicare reassignment (form CMS-855R): South Shore Mental Health Center, Inc. (NPI 1770528317, Quincy, MA); Northeast Behavioral Health, LLC (NPI 1275920001, Dartmouth, MA); Cornerstone Wellness Center PC (NPI 1285418681, Dartmouth, MA); Olivier Group, P.C. (NPI 1316198690, N Dartmouth, MA); Movement Wellness (NPI 1265267231, New Bedford, MA); and 1 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** May 19, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1710612239) · Data from the CMS NPPES public registry.