Individual provider Active NPI

Ellen June Middleton, NP

  • Obstetrics & Gynecology Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1245301340
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
7968 Issued in CA
Practice address
2210 E Illinois Ave Ste 408
Fresno, CA 93701-2184
Phone
(559) 443-2694
Fax
(559) 443-2696
NPI assigned
Nov 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 7968 CA Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 333601 CA

Addresses

Primary practice location

2210 E Illinois Ave Ste 408
Fresno, CA 93701-2184

Mailing address

2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 443-2682

Other identifiers 1

IdentifierTypeStateIssuer
RN333601MedicaidCA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803001377 CA Practitioner - Nurse Practitioner 7810933157 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central California Faculty Medical Group IncGroup PAC ID 8325952773, 256 clinicians

Practice addresses (Care Compare)

2210 E Illinois Ave
Suite 408
Fresno, CA 93701-2184
Phone (559) 443-2694

Hospital & facility affiliations

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

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7968CAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Faculty Associates, Inc. Obstetrics & Gynecology CurrentSince Apr 1, 2015 Accepting new patients
Central California Faculty Medical Group, Inc. Current Accepting new patients
University Faculty Associates , Inc. CurrentSince Apr 1, 2015 Accepting new patients
University Faculty Associates, Inc. Past Accepting new patients

Locations

290 N Wayte Ln
Fresno, CA 93701
Phone (559) 459-4101

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

2210 E Illinois Ave
Ste 408
Fresno, CA 93701
Phone (559) 443-2694

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 270
Fresno, CA 93701
Phone (559) 445-1251

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

Interoperability endpoints

  • Direct secure messaging: ellen.middleton.1@31788.direct.athenahealth.com

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": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1245301340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431",
            "telephone_number": "559-443-2682",
            "fax_number": "559-443-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 E ILLINOIS AVE STE 408",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012184",
            "telephone_number": "559-443-2694",
            "fax_number": "559-443-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "ELLEN",
        "middle_name": "JUNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-11",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "7968",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "333601",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN333601",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.