Individual provider Active NPI

Stefan I Pentschev, M.D.

  • Family Medicine Physician
  • Exeter, CA
National Provider Identifier
1154344927
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A43893 Issued in CA
Practice address
330 E Pine St
Exeter, CA 93221-1838
Phone
(559) 592-2134
Fax
(559) 592-5017
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A43893 CA Primary

Addresses

Primary practice location

330 E Pine St
Exeter, CA 93221-1838

Mailing address

330 E Pine St
Exeter, CA 93221-1838
Phone (559) 592-2134

Other identifiers 1

IdentifierTypeStateIssuer
00A438930MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080717000462 CA Practitioner - General Practice 7810807161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Healthcare NetworkGroup PAC ID 6305756339, 91 clinicians

Practice addresses (Care Compare)

330 E Pine St
Exeter, CA 93221-1838
Phone (877) 960-3426

785 E Manning Ave
Reedley, CA 93654-2231
Phone (559) 332-1112

Hospital & facility affiliations

  • Adventist Health Home Care Services Home health agency, Hanford, CA, CCN 057477

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A43893CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stefan Pentschev MD Medical Corporation Family Medicine CurrentSince Nov 15, 2024 Accepting new patients
Family Healthcare Network Past Accepting new patients
San Joaquin Prime Care Medical Group Inc. Family Medicine Past Accepting new patients

Locations

30926 E Kings Canyon Rd
Squaw Valley, CA 93675
Phone (559) 332-1112

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1154344927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E PINE ST",
            "city": "EXETER",
            "state": "CA",
            "postal_code": "932211838",
            "telephone_number": "559-592-2134",
            "fax_number": "559-592-5017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E PINE ST",
            "city": "EXETER",
            "state": "CA",
            "postal_code": "932211838",
            "telephone_number": "559-592-2134",
            "fax_number": "559-592-5017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTSCHEV",
        "first_name": "STEFAN",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A43893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A438930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, CA

Sources for this page

Verify at the official NPI Registry.