NPIMap

Individual provider Active NPI

Stephanie Yasmine Pablo, MD

  • Family Medicine Physician
  • Fresno, CA
National Provider Identifier
1164051991
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A184680 Issued in CA
Practice address
4711 W Ashlan Ave
Fresno, CA 93722-4307
Phone
(559) 203-6640
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 1

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central California Faculty Medical Group Inc 256 clinicians
Valley Health Team, Inc. 14 clinicians

Practice addresses (Care Compare)

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 459-6000

449 S Madera Ave
Kerman, CA 93630-1537
Phone (559) 846-9359

Hospital & facility affiliations

  • Community Regional Medical Center Hospital, Fresno, CA, CCN 050060

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as group
Quality
76.71
Promoting interoperability
100
Improvement activities
40
Cost
74

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240610003963 CA Practitioner - Family Practice 1658726914 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Central California Faculty Medical Group, Inc. CurrentSince Dec 1, 2024 Accepting new patients
University Faculty Associates, Inc. Family Medicine CurrentSince Apr 30, 2024 Accepting new patients
Central California Faculty Medical Group, Inc. Family Medicine CurrentSince Dec 1, 2024 Accepting new patients
University Faculty Associates , Inc. CurrentSince Apr 30, 2024 Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients

Locations

2335 E Kashian Ln
Ste 410
Fresno, CA 93701
Phone (559) 266-4100

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

2625 E Divisadero St
Fresno, CA 93721
Phone (559) 453-5200

2335 E Kashian Ln
Ste 240
Fresno, CA 93701
Phone (559) 320-0545

Interoperability endpoints

  • Direct secure messaging: stephanie.pablo.p4@direct.vht.nextgenshare.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A184680 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

4711 W Ashlan Ave
Fresno, CA 93722-4307

Mailing address

PO Box 737
San Joaquin, CA 93660-0737

Other practice location 1

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 443-2682

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 25, 2024.

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1164051991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 737",
            "city": "SAN JOAQUIN",
            "state": "CA",
            "postal_code": "936600737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 W ASHLAN AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937224307",
            "telephone_number": "559-203-6640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2823 Fresno St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937211324",
            "country_code": "US",
            "telephone_number": "559-443-2682",
            "fax_number": "559-443-2681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PABLO",
        "first_name": "STEPHANIE",
        "middle_name": "YASMINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A184680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.