NPIMap

Organization Active NPI

Fogg Remington Eyecare Inc

  • Ophthalmology Physician
  • Fresno, CA
National Provider Identifier
1023070869
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
FOGG REMINGTON EYECARE INC
Practice address
1360 E Herndon Ave
Suite 401
Fresno, CA 93720-3326
Phone
(559) 449-5010
Fax
(559) 449-5014
NPI assigned
Apr 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Paula Pendley
Title
Credentialing
Phone
(559) 226-3975

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1360 E Herndon Ave
Suite 401
Fresno, CA 93720-3326

Mailing address

1360 E Herndon Ave
Suite 401
Fresno, CA 93720-3326
Phone (559) 449-5010

Other practice location 1

2401 W Cleveland Ave
Madera, CA 93637-3608
Phone (559) 449-5010

Other practice location 2

1817 Shaw Ave Ste 104
Clovis, CA 93611-4069
Phone (559) 449-5010

Other practice location 3

3830 N 1st St
Fresno, CA 93726-4301
Phone (559) 449-5010

Other identifiers 2

IdentifierTypeStateIssuer
GR0078922MedicaidCA
1304310002OtherCACIGNA MEDICARE DMERC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423001093 CA Part B Supplier - Clinic/Group Practice 7911993902 Receives reassigned benefits from 30 practitioners
5 other NPIs on this enrollment
Practice locations: Clovis, CA; Fresno, CA; Madera, CA; Oakhurst, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Foggmaxwell Lanier E8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 31

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1023070869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 E HERNDON AVE",
            "address_2": "SUITE 401",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203326",
            "telephone_number": "559-449-5010",
            "fax_number": "559-449-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 E HERNDON AVE",
            "address_2": "SUITE 401",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203326",
            "telephone_number": "559-449-5010",
            "fax_number": "559-449-5014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 W Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Madera",
            "state": "CA",
            "postal_code": "936373608",
            "country_code": "US",
            "telephone_number": "559-449-5010",
            "fax_number": "559-449-5014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1817 Shaw Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "CA",
            "postal_code": "936114069",
            "country_code": "US",
            "telephone_number": "559-449-5010",
            "fax_number": "559-449-5014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3830 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937264301",
            "country_code": "US",
            "telephone_number": "559-449-5010",
            "fax_number": "559-449-5014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOGG REMINGTON EYECARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2020-10-10",
        "status": "A",
        "authorized_official_last_name": "PENDLEY",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "559-226-3975",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0078922",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE DMERC",
            "identifier": "1304310002",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.