PRINCEWILL FONTA PMHNP
NPI 1710612239
Nurse Practitioner - Psychiatric/Mental Health in Olympia, WA

Q: 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.

Q: 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.

Q: 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 2 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.

Active since July 19, 2022PECOS Enrolled

711 STATE AVE NE, OLYMPIA, WA 98506(360) 943-0780 Get Directions Write a Review

NPPES record last updated: May 19, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 19, 2026, Oct 11, 2024, Jul 19, 2022 (3 updates tracked since 2022).

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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, is affiliated with Southcoast Hospitals Group, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1710612239

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NamePRINCEWILL FONTACredential: PMHNP

Location Address711 STATE AVE NEOlympia, WA 98506-3984

Mailing Address711 State Ave NeOlympia, WA 98506-3984 · (360) 943-0780

Phone(360) 943-0780

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateJuly 19, 2022

Last NPPES UpdateMay 19, 20263 updates tracked since enumeration

NPPES CertifiedMay 19, 2026

✔ NPI 1710612239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Licenses✔ Licensed in WA · AP70059722✔ Licensed in DE · L8-0010342✔ Licensed in MA · RN2307255

711 STATE AVE NE, Olympia, WA 98506

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Princewill Fonta Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID648644831

PECOS Enrollment IDI20230330001886

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.

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

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.

128 services47 patients

Psychiatric diagnostic evaluation 90791

A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Southcoast Hospitals Group

Acute Care Hospitals · Fall River, MA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220074

Location363 Highland AvenueFall River, MA 02720 · Bristol County

Emergency services Birthing friendly

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.

New Patient

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

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.

TYRONE ALEXANDER CAWSTON AAC

Counselor