Individual provider Active NPI

Matthew Alan Stanich, MD

  • Anesthesiology Physician
  • Fresno, CA
National Provider Identifier
1235464181
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A115379 Issued in CA
Practice address
1360 E Spruce Ave Ste 101a
Fresno, CA 93720-3378
Phone
(559) 437-5610
NPI assigned
Oct 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A115379 CA Primary

Addresses

Primary practice location

1360 E Spruce Ave Ste 101a
Fresno, CA 93720-3378

Mailing address

1360 E Spruce Ave Ste 101a
Fresno, CA 93720-3378
Phone (559) 437-5610

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
I20220802003626 CA Practitioner - Anesthesiology 9436379419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of California, San Francisco School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants of FresnoGroup PAC ID 8527967082, 64 clinicians

Practice addresses (Care Compare)

1303 E Herndon Ave
Fresno, CA 93720-3309

1360 E Spruce Ave
Suite 101a
Fresno, CA 93720-3378
Phone (559) 437-5645

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A115379CAMDAnesthesiology Physician

Organizations & group practices 1

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 2

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": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1235464181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 E SPRUCE AVE STE 101A",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203378",
            "telephone_number": "559-437-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 E SPRUCE AVE STE 101A",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203378",
            "telephone_number": "559-437-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANICH",
        "first_name": "MATTHEW",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-09",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A115379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.