Individual provider Active NPI

Denard Manuel Fobbs Sr., M.D.

  • Gynecology Physician
  • Fresno, CA
National Provider Identifier
1184769879
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
C38922 Issued in CA
Practice address
5339 N Fresno St Ste 105E
Fresno, CA 93710-6851
Phone
(559) 225-7600
Fax
(559) 225-2472
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X C38922 CA Primary

Addresses

Primary practice location

5339 N Fresno St Ste 105E
Fresno, CA 93710-6851

Mailing address

PO Box 26990
Fresno, CA 93729-6990
Phone (559) 225-7600

Other identifiers 4

IdentifierTypeStateIssuer
0056972OtherCADRS' CO. MALPRACTICE INS.
2637617MedicaidCA
E8471OtherTXTEXAS LICENSE NUMBER
C38922OtherCACALIF. LICENSE NUMBER

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
I20120418000196 CA Practitioner - Obstetrics/Gynecology 1456512474 Practice locations: Fresno, CA

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Howard University College of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7455 N Fresno St
Suite 202
Fresno, CA 93720-2481
Phone (559) 225-7600

Hospital & facility affiliations

  • Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C38922CAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fresno Community Hospital and Medical Center Past Accepting new patients
Valley Children'S Hospital Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Organizations & group practices 3

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1184769879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26990",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937296990",
            "telephone_number": "559-225-7600",
            "fax_number": "559-225-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5339 N FRESNO ST STE 105E",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937106851",
            "telephone_number": "559-225-7600",
            "fax_number": "559-225-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOBBS",
        "first_name": "DENARD",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "C38922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRS' CO. MALPRACTICE INS.",
            "identifier": "0056972",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2637617",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LICENSE NUMBER",
            "identifier": "E8471",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIF. LICENSE NUMBER",
            "identifier": "C38922",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.