Individual provider Active NPI

Richard Conrad Shebelut, MD

  • Obstetrics & Gynecology Physician
  • Fresno, CA
National Provider Identifier
1285736058
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G471640 Issued in CA
Practice address
6327 N Fresno St Ste 101
Fresno, CA 93710-5236
Phone
(559) 439-2229
Fax
(559) 435-7195
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G471640 CA Primary

Addresses

Primary practice location

6327 N Fresno St Ste 101
Fresno, CA 93710-5236

Mailing address

6327 N Fresno St Ste 101
Fresno, CA 93710-5236
Phone (559) 439-2229

Other practice location 1

6215 N Fresno Street St 108
Fresno, CA 93710
Phone (559) 439-2229

Other identifiers 1

IdentifierTypeStateIssuer
CA238536OtherCAMEDICARE

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
I20040401001716 CA Practitioner - Obstetrics/Gynecology 8527050103 Reassigns benefits to 1 organization
Practice locations: Fresno, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G471640CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richard C Shebelut MD Inc Obstetrics & Gynecology CurrentSince Oct 14, 2012 Accepting new patients
Richard C Shebelut MD Obstetrics & Gynecology CurrentSince Apr 30, 2021 Accepting new patients
American Arthritis & Rheumatology Associates-Ca PC Past Accepting new patients
Omni Women'S Health Medical Group, Inc Past Accepting new patients
Omni Womens Health Medical Group Inc Past Accepting new patients

Locations

6215 N Fresno St
Ste 108
Fresno, CA 93710
Phone (559) 256-9600

6327 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-5265

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1285736058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6327 N FRESNO ST STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105236",
            "telephone_number": "559-439-2229",
            "fax_number": "559-439-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6327 N FRESNO ST STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105236",
            "telephone_number": "559-439-2229",
            "fax_number": "559-435-7195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6215 N Fresno Street St 108",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "93710",
            "country_code": "US",
            "telephone_number": "559-439-2229",
            "fax_number": "559-439-3936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEBELUT",
        "first_name": "RICHARD",
        "middle_name": "CONRAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2021-03-03",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G471640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "CA238536",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.