Visalia Family Practice Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

VISALIA FAMILY PRACTICE MEDICAL GROUP

Practice address

107 N Hall St Ste D
Visalia, CA 93291-5850

Phone

(559) 625-9200

Fax

(559) 625-0665

NPI assigned

Dec 1, 2006

Last updated

Jan 5, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Breana Bergdorf

Title

Administrator

Phone

(559) 625-9200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EAFIAA

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edgar H Clark, M.D.

  • Family Medicine Physician
  • Paradise, CA
  • NPI 1003847872
  Medicare reassignment Care Compare group NPD
• Monica M Joosten, FNP-C

  • Family Nurse Practitioner
  • Visalia, CA
  • NPI 1750916094
  Medicare reassignment Care Compare group NPD
• Christopher J. Rodarte, M.D.

  • Family Medicine Physician
  • Visalia, CA
  • NPI 1053383091
  Medicare reassignment Care Compare group NPD
• Mark V Tetz, M.D.

  • Family Medicine Physician
  • Visalia, CA
  • NPI 1891779138
  Medicare reassignment Care Compare group NPD
• Elena Voronejskaia, M.D.

  • Family Medicine Physician
  • Visalia, CA
  • NPI 1487006995
  Medicare reassignment Care Compare group NPD
• Kourtney Umphfres, PA-C

  • Physician Assistant
  • Exeter, CA
  • NPI 1528028321
  Medicare reassignment Care Compare group
• John C Booker, M.D.

  • Family Medicine Physician
  • Visalia, CA
  • NPI 1790769768
  Medicare reassignment NPD
• Thomas Edward Daglish, M.D.

  • Family Medicine Physician
  • Visalia, CA
  • NPI 1982688206
  Medicare reassignment NPD
• Elizabeth Miyo Sasaki, D.O.

  • Family Medicine Physician
  • Visalia, CA
  • NPI 1801829411
  Medicare reassignment NPD
• Paul J Schommer, M.D.

  • Family Medicine Physician
  • Visalia, CA
  • NPI 1730163064
  Medicare reassignment NPD
• Maria Yepiz-Wang, FNP-BC

  • Family Nurse Practitioner
  • Visalia, CA
  • NPI 1174927214
  Medicare reassignment NPD
• Violetta Suleymanova, M.D

  • Family Medicine Physician
  • Gilbert, AZ
  • NPI 1215469226

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672876800000",
    "number": "1073681730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N HALL ST STE D",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915850",
            "telephone_number": "559-625-9200",
            "fax_number": "559-625-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N HALL ST STE D",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915850",
            "telephone_number": "559-625-9200",
            "fax_number": "559-625-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISALIA FAMILY PRACTICE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "BERGDORF",
        "authorized_official_first_name": "BREANA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "559-625-9200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Visalia Eye Center, Inc. (Visalia Eye Center)
• Visalia Eye Center, Inc. (Visalia Eye Center)
• Visalia Faculty Medical Group Inc.
• Visalia Family Eye Care Optometry PC
• Visalia Family Medicine Group Inc
• Visalia Hearing Center, Inc.
• Visalia Kidney Center LLC (Ara Kaweah Dialysis Center)
• Visalia Medical Clinic, Inc
• Visalia Medical Clinic, Inc.
• Visalia Medical Clinic, Inc.

• Family Medicine Physician in Visalia, CA
• Providers in Visalia, 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 Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.