NPIMap

Individual provider Active NPI

Cosmo Lyle Fraser, MD

  • Nephrology Physician
  • Yuba City, CA
National Provider Identifier
1215026760
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
C40203 Issued in CA
Practice address
2115 E Onstott Rd
Yuba City, CA 95991-1556
Phone
(530) 751-0339
Fax
(530) 751-0449
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X C40203 CA Primary

Addresses

Primary practice location

2115 E Onstott Rd
Yuba City, CA 95991-1556

Mailing address

220 Standiford Ave
Ste F
Modesto, CA 95350-1159
Phone (209) 579-5628

Other identifiers 1

IdentifierTypeStateIssuer
00C402030MedicaidCA

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
I20120404000755 CA Practitioner - NephrologyPractitioner - Internal Medicine 7012825417 Practice locations: Yuba City, CA

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
New York University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2115 E Onstott Rd
Yuba City, CA 95991-1556
Phone (530) 751-0399

2115 E Onstott Rd
Yuba City, CA 95991-1587

Hospital & facility affiliations

  • Yuba Sutter Dialysis Dialysis facility, Yuba City, CA, CCN 052877
  • DaVita Marysville Dialysis Center Dialysis facility, Marysville, CA, CCN 552533
  • Adventist Health and Rideout Hospital, Marysville, CA, CCN 050133
  • Oroville Hospital Hospital, Oroville, CA, CCN 050030
  • Colusa Medical Center Hospital, Colusa, CA, CCN 050783
  • Orchard Hospital Hospital, Gridley, CA, CCN 051311
  • Enloe Health Hospital, Chico, CA, CCN 050039

Merit-based Incentive Payment System (MIPS)

Final score
22.3 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
74.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C40203CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cosmo L Fraser, MD Nephrology CurrentSince Aug 26, 2012 Accepting new patients
Ara-Yuba City Dialysis LLC PastSince May 1, 2020 Accepting new patients
Rideout Memorial Hospital Past Accepting new patients

Locations

220 Standiford Ave
Ste F
Modesto, CA 95350
Phone (209) 589-1500

2115 E Onstott Rd
Ste 100
Yuba City, CA 95991

2115 E Onstott Rd
Yuba City, CA 95991
Phone (530) 751-0339

Interoperability endpoints

  • Direct secure messaging: cosmo.fraser@direct.davitaphysiciansolutions.com

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 7

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1215026760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 STANDIFORD AVE",
            "address_2": "STE F",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501159",
            "telephone_number": "209-579-5628",
            "fax_number": "209-579-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 E ONSTOTT RD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959911556",
            "telephone_number": "530-751-0339",
            "fax_number": "530-751-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "COSMO",
        "middle_name": "LYLE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "C40203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C402030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuba City, CA

Sources for this page

Verify at the official NPI Registry.