Active NPI
Harry Kallas, M.D.
- Pediatric Critical Care Medicine Physician
- Fresno, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- G81209
- Practice address
- 6235 N Fresno St
Suite # 103
Fresno, CA 93710-5269 - Phone
- (559) 449-4350
- Fax
- (559) 449-4358
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | G81209 | CA | Primary |
Addresses
Primary practice location
6235 N Fresno St
Suite # 103
Fresno, CA 93710-5269
Mailing address
6235 N Fresno St
Suite # 103
Fresno, CA 93710-5269
Phone (559) 449-4350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ71868Z | Medicaid | CA |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041202000455 | CA | Practitioner - Pediatric Medicine | 6204892193 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G81209 | CA | MD | Pediatric Critical Care Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Anesthesia Associates Medical Group Inc | Pediatric Critical Care Medicine | Current | Accepting new patients |
| Valley Children'S Medical Group | Past | Accepting new patients |
Locations
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
6235 N Fresno St
Fresno, CA 93710
Phone (559) 229-3668
6235 N Fresno St
Ste 103
Fresno, CA 93710
Phone (559) 449-4350
9300 Valley Childrens Pl
#63
Madera, CA 93636
Phone (559) 353-5542
9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700
9300 Valley Childrens Pl
Ste FE10
Madera, CA 93636
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Madera, CA
- NPI 1558588871
CA, Pediatric Critical Care Medicine
-
- Pediatrics Physician
- Modesto, CA
- NPI 1437555265
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406246400000",
"number": "1134214901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6235 N FRESNO ST",
"address_2": "SUITE # 103",
"city": "FRESNO",
"state": "CA",
"postal_code": "937105269",
"telephone_number": "559-449-4350",
"fax_number": "559-449-4358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6235 N FRESNO ST",
"address_2": "SUITE # 103",
"city": "FRESNO",
"state": "CA",
"postal_code": "937105269",
"telephone_number": "559-449-4350",
"fax_number": "559-449-4358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALLAS",
"first_name": "HARRY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2014-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "CA",
"license": "G81209",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZZ71868Z",
"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 Jul 25, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.