GRACE FANTL (PA-C) – Physician Assistant, NPI 1710461595

GRACE FANTL (PA-C) is a healthcare provider. based in N dartmouth, Massachusetts. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA8620 (MA). The NPI Number for GRACE FANTL (PA-C) is 1710461595

Main info

Female
8 Years Of Experience
Name
GRACE FANTL (PA-C)
NPI
1710461595
Phone
(508) 993-7601
Address
145 Faunce Corner Mall Rd
Enumeration Date
18 September 2018
Last Update Date
24 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5086997546
Graduation Year
2018 (8 years ago)
PAC ID
0840536892
Group Practice PAC ID
3779860390
Professional Enrollment ID
I20220915001504
Address ID
MA027602312NO153XXSTXX400

Contacts

Secure Messaging
lfournier@dsiderm.emadirect.md
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness95
Years active:7State licenses:1Other names

5,091 PHYSICIAN ASSISTANT in MA

Provider Addresses for GRACE FANTL (PA-C)

  • 145 Faunce Corner Mall Rd

    N Dartmouth, MA 027476216

    Phone: (508) 993-7601

    Fax: (508) 997-0523

    Type: Location

  • 153 E Washington St

    North Attleboro, MA 027602312

    Phone: (508) 699-7546

    Fax: (508) 699-7570

    Type: Location

  • 27950 US HIGHWAY 27

    LEESBURG, FL 347489050

    Phone: (352) 350-5230

    Type: Mailing

  • 145 FAUNCE CORNER MALL RD

    N DARTMOUTH, MA 027476216

    Phone: (508) 993-7601

    Fax: (508) 997-0523

    Type: Mailing

  • 526 MAIN ST STE 302

    ACTON, MA 017203301

    Phone: (978) 371-7010

    Fax: (978) 371-0522

    Type: Mailing

  • 829 AMERICAN LEGION HWY

    WESTPORT, MA 027904128

    Phone: (508) 306-1400

    Fax: (978) 371-0522

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 27 Open Payments records for all available years, with a total value of $1,006.

Total Amount is formed as General ($1,006) + Research ($0) + Ownership ($0) = $1,006.

Last reported payment date: 2024-12-16 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($236).

Total Amount

$1,006

General + Research + Ownership

Payments

27

Total payment records

General Amount

$1,006

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-16

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-09-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220915001504IPhysician AssistantMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths916190$0
99213Established patient office or other outpatient visit, 20-29 minutes620465$0
17000Destruction of precancer skin growth, 1 growth310271$0
17110Destruction of skin growth, 1-14 growths194152$0
99203New patient office or other outpatient visit, 30-44 minutes151151$0
View full utilization report →

Insurance plans in this area (ZIP 02747)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3779860390View full group profile
NameSpecialtyState
D E R M A T O L O G YMA
D E R M A T O L O G YMA
Nurse PractitionerMA
Nurse PractitionerMA

Reviews

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Frequently asked questions

What is the registry number for GRACE FANTL (PA-C)?
The registry entry for GRACE FANTL (PA-C) shows NPI 1710461595.
Is GRACE FANTL (PA-C)'s NPI status active today?
Active status means GRACE FANTL (PA-C)'s NPI record is not deactivated in the public file.
What does the directory say GRACE FANTL (PA-C) does?
Insurance directories may phrase it differently, but here GRACE FANTL (PA-C) maps to Physician Assistant. Clinical services aligned with this taxonomy classification.
What geographic area is tied to GRACE FANTL (PA-C)?
GRACE FANTL (PA-C) is associated with N Dartmouth, Massachusetts in the same public data insurers reference.
Can I export GRACE FANTL (PA-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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