DR. LARRY L JR. FONTANILLA (MD) – Emergency Medicine Physician, NPI 1518908797

DR. LARRY L JR. FONTANILLA (MD) is a healthcare provider. based in Lacey, Washington. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. MD00043682 (WA). The NPI Number for DR. LARRY L JR. FONTANILLA (MD) is 1518908797

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
DR. LARRY L JR. FONTANILLA (MD)
NPI
1518908797
Phone
(800) 599-0166
Address
PO BOX 5007
Enumeration Date
9 June 2006
Last Update Date
27 November 2007

Doctor Profile

Medical School Name
UNIVERSITY OF HAWAII JOHN A. BURNS SCHOOL OF MEDICINE
Secondary Phone
3604934554
Graduation Year
1999 (27 years ago)
PAC ID
3971580275
Group Practice PAC ID
9335035633
Professional Enrollment ID
I20040706000309
Address ID
WA985065133OL413XXNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,206 EMERGENCY MEDICINE in WA

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Provider Addresses for DR. LARRY L JR. FONTANILLA (MD)

  • Lacey Square, Cashel, The Municipal District of Cahir — Cashel, County Tipperary, Munster, E25 RD21, Ireland

    LACEY, WA 985095007

    Phone: (800) 599-0166

    Type: Mailing

  • Providence St. Peter Hospital, 413, Lilly Road Northeast, Olympia, Thurston County, Washington, 98506, United States

    OLYMPIA, WA 985065133

    Phone: (360) 491-9480

    Type: Location

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: 2004-07-06

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
I20040706000309IEmergency MedicineWATBD

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
99285Emergency department visit with high level of medical decision making9695$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only6059$0
99284Emergency department visit with moderate level of medical decision making3737$0
93042Electrocardiogram (ecg) 1 to 3 leads with review by physician only2121$0
99291Critical care, first 30-74 minutes2020$0
View full utilization report →

Insurance plans in this area (ZIP 98509)

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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: 9335035633View full group profile
NameSpecialtyState
Emergency MedicineWA
Emergency MedicineWA
Emergency MedicineTX
Emergency MedicinePA
-WA
Emergency MedicineTX
Emergency MedicineWA
Emergency MedicineWA
-WA
Emergency MedicineKY

Reviews

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Frequently asked questions

What is the standard ID for DR. LARRY L JR. FONTANILLA (MD) in the U.S.?
In the U.S., DR. LARRY L JR. FONTANILLA (MD) is identified by NPI 1518908797.
Does the public listing show DR. LARRY L JR. FONTANILLA (MD) as active?
DR. LARRY L JR. FONTANILLA (MD)'s NPI record reflects an active status in NPPES.
What type of care does DR. LARRY L JR. FONTANILLA (MD) provide?
DR. LARRY L JR. FONTANILLA (MD)'s profile centers on Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DR. LARRY L JR. FONTANILLA (MD) tied to Lacey, Washington?
If you are local to Lacey, Washington, DR. LARRY L JR. FONTANILLA (MD) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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