Vira Fomenko, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A164062 Issued in CA

Practice address

2400 Moorpark Ave Ste 300
San Jose, CA 95128-2680

Phone

(408) 975-2730

Fax

(408) 975-2764

NPI assigned

Mar 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Un of California, Irvine, College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vfomenko603766@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Asian Americans for Community Involvement of Santa Clara County, Inc

  • Clinic/Center
  • San Jose, CA
  • NPI 1750490363
  Medicare reassignment NPD
• Asian Americans for Community Involvement of Santa Clara County, Inc

  • Clinic/Center
  • San Jose, CA
  • NPI 1316338775
  NPD
• Asian Americans for Community Involvement of Santa Clara County, Inc

  • Community/Behavioral Health Agency
  • San Jose, CA
  • NPI 1326052291
  NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510

  Family Medicine

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• County of Santa Clara

  dba Inpatient Acute/Outpatient Facility Services

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1063406551
  Care Compare affiliation

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1023512456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 MOORPARK AVE STE 300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282680",
            "telephone_number": "408-975-2730",
            "fax_number": "408-975-2764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MOORPARK AVE STE 300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282680",
            "telephone_number": "408-975-2730",
            "fax_number": "408-975-2764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Hospital Pkwy",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951191103",
            "country_code": "US",
            "telephone_number": "408-972-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOMENKO",
        "first_name": "VIRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A164062",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "250 Hospital Pkwy",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951191103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lina Foketi
• Teresa Folan, R.N.
• Darren Folk, LCSW
• Nicole Marie Folliott
• Keith Elliott Follmar, M.D.
• Abraham Park Fong, MD, PHD
• Allen Gary Fong, M.D.
• Andrew B. Fong, D.D.S.
• Cynthia Uyemoto Fong, PT
• Daniel Jordan Fong, DPT

• Family Medicine Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.