NPIMap

Organization Active NPI

Express Care Medical Group, a Professional Corporation

  • Internal Medicine Physician
  • Clovis, CA
National Provider Identifier
1124886882
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EXPRESS CARE MEDICAL GROUP, A PROFESSIONAL CORPORATION
Practice address
2131 Herndon Ave Ste 103
Clovis, CA 93611-6304
Phone
(559) 578-8844
Fax
(559) 578-8899
NPI assigned
Mar 7, 2024
Last updated
Sep 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Authorized official

Name
Mr. Dennis Malate Redubla, NP-CNPI 1053633206
Title
Owner
Phone
(559) 840-2727

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2131 Herndon Ave Ste 103
Clovis, CA 93611-6304

Mailing address

685 W Alluvial Ave Ste 103
Fresno, CA 93711-5779
Phone (559) 499-1233

Other practice location 1

3069 Tulare St
Fresno, CA 93721-1434
Phone (559) 412-8812

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240522004198 CA Part B Supplier - Clinic/Group Practice 7315389376 Receives reassigned benefits from 5 practitioners
Practice locations: Clovis, CA; Fresno, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1124886882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 W ALLUVIAL AVE STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115779",
            "telephone_number": "559-499-1233",
            "fax_number": "559-499-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 HERNDON AVE STE 103",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116304",
            "telephone_number": "559-578-8844",
            "fax_number": "559-578-8899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3069 Tulare St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937211434",
            "country_code": "US",
            "telephone_number": "559-412-8812",
            "fax_number": "559-578-8899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXPRESS CARE MEDICAL GROUP, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-07",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "REDUBLA",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "MALATE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-840-2727",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; 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.