Active NPI
Stephen Cooley, PA
- Physician Assistant
- Fresno, CA
National Provider Identifier
1306304704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA56625
- Practice address
- 7115 N Chestnut Ave Ste 101
Fresno, CA 93720-0361 - Phone
- (559) 431-2397
- Fax
- (559) 472-3382
- NPI assigned
- Mar 5, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA56625 | CA | Primary |
Addresses
Primary practice location
7115 N Chestnut Ave Ste 101
Fresno, CA 93720-0361
Mailing address
7115 N Chestnut Ave Ste 101
Fresno, CA 93720-0361
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7115 N Chestnut Ave
Suite 101
Fresno, CA 93720-0361
Phone (559) 431-2397
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA56625 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Direct Dermatology Professionals PC | Dermatology | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Dermatology Physician
- Fresno, CA
- NPI 1871882712
-
- Dermatology Physician
- Manteca, CA
- NPI 1417263922
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551744000000",
"number": "1306304704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7115 N CHESTNUT AVE STE 101",
"city": "FRESNO",
"state": "CA",
"postal_code": "937200361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7115 N CHESTNUT AVE STE 101",
"city": "FRESNO",
"state": "CA",
"postal_code": "937200361",
"telephone_number": "559-431-2397",
"fax_number": "559-472-3382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOLEY",
"first_name": "STEPHEN",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-05",
"last_updated": "2019-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA56625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.