Individual provider Active NPI

Geetha Sivasubramanian, MD

  • Infectious Disease Physician
  • Fresno, CA
National Provider Identifier
1306089479
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
C168863 Issued in CA
Practice address
2335 E Kashian LN Ste 280
Fresno, CA 93701-2211
Phone
(559) 320-1090
Fax
(559) 320-0331
NPI assigned
Apr 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C168863 CA
Infectious Disease Physician 207RI0200X C168863 CA Primary

Addresses

Primary practice location

2335 E Kashian LN Ste 280
Fresno, CA 93701-2211

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
F400140717OtherILMEDICARE PTAN COOK COUNTY
036125495MedicaidIL
F400140718OtherILMEDICARE PTAN MCHENRY COUNTY

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
I20200902003303 CA Practitioner - Infectious Disease 6507055100 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central California Faculty Medical Group IncGroup PAC ID 8325952773, 256 clinicians

Practice addresses (Care Compare)

2335 E Kashian LN
Suite 280
Fresno, CA 93701-2211
Phone (559) 320-1090

Hospital & facility affiliations

  • Community Regional Medical Center Hospital, Fresno, CA, CCN 050060
  • Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492
  • Adventist Health Hanford Hospital, Hanford, CA, CCN 050121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C168863CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Faculty Associates, Inc. Internal Medicine CurrentSince Sep 15, 2020 Accepting new patients
Central California Faculty Medical Group, Inc. Internal Medicine CurrentSince Dec 1, 2024 Accepting new patients
LQMG Medical Group Inc. Internal Medicine Current Accepting new patients
Saint Agnes Medical Foundation Internal Medicine CurrentSince Nov 1, 2021 Accepting new patients
Central California Faculty Medical Group, Inc. CurrentSince Dec 1, 2024 Accepting new patients
United Health Centers of the San Joaquin Valley Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

2315 E Illinois Ave
Fresno, CA 93701
Phone (559) 459-4243

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

7202 N Millbrook Ave
Ste 105
Fresno, CA 93720
Phone (559) 450-4463

2625 E Divisadero St
Fresno, CA 93721
Phone (559) 453-5200

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

290 N Wayte Ln
Ste 2300
Fresno, CA 93701
Phone (594) 595-1935

1221 E Spruce Ave
Fresno, CA 93720
Phone (559) 449-5777

2335 E Kashian Ln
Ste 280
Fresno, CA 93701
Phone (559) 256-5130

Interoperability endpoints

  • Direct secure messaging: geetha.sivasubramanian.1@17661.direct.athenahealth.com
  • Direct secure messaging: geetha.sivasubramanian.1@31788.direct.athenahealth.com

Organizations & group practices 7

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 3

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": "1240099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1306089479",
    "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": "2335 E KASHIAN LN STE 280",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012211",
            "telephone_number": "559-320-1090",
            "fax_number": "559-320-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVASUBRAMANIAN",
        "first_name": "GEETHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-19",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C168863",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "C168863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN  COOK COUNTY",
            "identifier": "F400140717",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036125495",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN  MCHENRY COUNTY",
            "identifier": "F400140718",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.