Individual provider Active NPI

Mirwaise Qader, PA-C

  • Physician Assistant
  • Fresno, CA
National Provider Identifier
1265294946
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA64065 Issued in CA
Practice address
2740 S Elm Ave
Fresno, CA 93706-5435
Phone
(559) 457-5200
Fax
(559) 457-5296
NPI assigned
Jan 29, 2024
Last updated
Jan 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA64065 CA Primary

Addresses

Primary practice location

2740 S Elm Ave
Fresno, CA 93706-5435

Mailing address

2740 S Elm Ave
Fresno, CA 93706-5435
Phone (559) 457-5200

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
I20260217002717 CA Practitioner - Physician Assistant 5496235590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinica Sierra VistaGroup PAC ID 3870407505, 180 clinicians

Practice addresses (Care Compare)

2740 S Elm Ave
Fresno, CA 93706-5435
Phone (559) 457-5200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
64065CAMDGeneral Practice Dentistry
PA64065CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Sierra Vista CurrentSince Feb 9, 2026 Accepting new patients
Clinica Sierra Vista CurrentSince Feb 9, 2026 Accepting new patients

Locations

1350 S Orange Ave
Fresno, CA 93702
Phone (559) 457-5400

2740 S Elm Ave
Fresno, CA 93706
Phone (559) 457-5200

Interoperability endpoints

  • Direct secure messaging: mirwaise.qader.1@17661.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1265294946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 S ELM AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937065435",
            "telephone_number": "559-457-5200",
            "fax_number": "559-457-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 S ELM AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937065435",
            "telephone_number": "559-457-5200",
            "fax_number": "559-457-5296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QADER",
        "first_name": "MIRWAISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-29",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.