DR. JOHN M FANNING (DO) – Family Medicine Physician, NPI 1053494435

DR. JOHN M FANNING (DO) is a healthcare provider. based in Ridley park, Pennsylvania. specializing in Family Medicine Physician. They hold the professional credentials DO. They hold a License No. OS003967L (PA). The NPI Number for DR. JOHN M FANNING (DO) is 1053494435

Main info

Male
49 Years Of Experience
Accepts Medicare Assignment
Name
DR. JOHN M FANNING (DO)
NPI
1053494435
Phone
(610) 595-6850
Address
8 MORTON AVE
Enumeration Date
23 October 2006
Last Update Date
21 September 2012

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
-
Graduation Year
1977 (49 years ago)
PAC ID
0941230155
Group Practice PAC ID
5698065142
Professional Enrollment ID
I20050817000742
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for DR. JOHN M FANNING (DO)

  • 8, North Morton Avenue, Leedom Estates, Ridley Park, Delaware County, Pennsylvania, 19078, United States

    SUITE 303

    RIDLEY PARK, PA 190782210

    Phone: (610) 595-6850

    Fax: (610) 595-6892

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2005-08-17

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
I20050817000742IFamily PracticePATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 19078)

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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: 5698065142View full group profile

Reviews

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Frequently asked questions

How do I look up DR. JOHN M FANNING (DO) by NPI?
Use NPI 1053494435 when you need to reference DR. JOHN M FANNING (DO) in forms, claims, or directories.
Does this profile mean DR. JOHN M FANNING (DO) is currently active?
Yes — DR. JOHN M FANNING (DO) appears active in the national provider directory.
What kind of provider is DR. JOHN M FANNING (DO)?
The page reflects Family Medicine Physician for DR. JOHN M FANNING (DO). Clinical services aligned with this taxonomy classification.
Where does public data place DR. JOHN M FANNING (DO)?
The snapshot lists Ridley Park, Pennsylvania for DR. JOHN M FANNING (DO); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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