DR. ALBERT FONTICOBA (OD) – Optometrist, NPI 1093710402

DR. ALBERT FONTICOBA (OD) is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. OEG000907 (PA). The NPI Number for DR. ALBERT FONTICOBA (OD) is 1093710402

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
DR. ALBERT FONTICOBA (OD)
NPI
1093710402
Phone
(215) 463-5889
Address
330 W OREGON AVE
Enumeration Date
14 June 2005
Deactivation Date
17 March 2006
Reactivation Date
23 March 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
PENNSYLVANIA COLLEGE OF OPTOMETRY
Secondary Phone
2154635889
Graduation Year
1989 (37 years ago)
PAC ID
6709001191
Professional Enrollment ID
I20140626002175
Address ID
PA191484723PH330XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,771 OPTOMETRY in PA

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Provider Addresses for DR. ALBERT FONTICOBA (OD)

  • Oregon Avenue, Whitman, South Philadelphia, Philadelphia, Philadelphia County, Pennsylvania, 19148, United States

    PHILADELPHIA, PA 191484723

    Phone: (215) 463-5889

    Fax: (215) 755-6959

    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: 2014-06-26

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
I20140626002175IOptometryPATBD

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
92250Photography of the retina2524$0
99204New patient office or other outpatient visit, 45-59 minutes2121$0
99215Established patient office or other outpatient visit, 40-54 minutes1717$0
View full utilization report →

Insurance plans in this area (ZIP 19148)

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Reviews

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Frequently asked questions

Can I verify DR. ALBERT FONTICOBA (OD) with an NPI only?
You can start verification with NPI 1093710402 for DR. ALBERT FONTICOBA (OD), then check state licensing separately.
Is DR. ALBERT FONTICOBA (OD) listed as active for patients and plans?
The listing shows DR. ALBERT FONTICOBA (OD) as active in the NPI system.
What healthcare role does DR. ALBERT FONTICOBA (OD) hold?
Scheduling teams often label DR. ALBERT FONTICOBA (OD) under Optometrist. Clinical services aligned with this taxonomy classification.
Where is DR. ALBERT FONTICOBA (OD) based?
DR. ALBERT FONTICOBA (OD) is tied to Philadelphia, Pennsylvania in the data we show; additional addresses may exist on the full record.
Is the information about DR. ALBERT FONTICOBA (OD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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