Individual provider Active NPI

Abdul Khaliq Alcozie

  • Internal Medicine Physician
  • Fresno, CA
National Provider Identifier
1306406277
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A191705 Issued in CA
Practice address
2823 Fresno St
Fresno, CA 93721-1324
Phone
(559) 603-7378
NPI assigned
Jun 13, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A191705 CA Primary
Family Medicine Physician 207Q00000X A191705 CA

Addresses

Primary practice location

2823 Fresno St
Fresno, CA 93721-1324

Mailing address

45 E River Park PL W FL 5
Fresno, CA 93720-1562
Phone (559) 603-7378

Other practice location 1

2755 Herndon Ave
Clovis, CA 93611-6800
Phone (559) 603-7300

Other practice location 2

15 E Audubon Dr
Fresno, CA 93720-1542
Phone (559) 433-8000

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
I20240603003585 CA Practitioner - Internal Medicine 1052748621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health PartnersGroup PAC ID 6608280268, 497 clinicians

Practice addresses (Care Compare)

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 459-6000

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A191705CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Partners Single Specialty CurrentSince Jun 1, 2024 Accepting new patients
Ozark Valley Medical Clinic, LLC Family Medicine Past Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

15 E Audubon Dr
Fresno, CA 93720
Phone (559) 433-8000

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

45 E River Park Pl W
Ste 104
Fresno, CA 93720
Phone (559) 320-0550

805 W Acequia Ave
Ste 2D
Visalia, CA 93291
Phone (559) 622-8687

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.

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": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1306406277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 E RIVER PARK PL W FL 5",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937201562",
            "telephone_number": "559-603-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211324",
            "telephone_number": "559-603-7378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2755 Herndon Ave",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "CA",
            "postal_code": "936116800",
            "country_code": "US",
            "telephone_number": "559-603-7300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 E Audubon Dr",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937201542",
            "country_code": "US",
            "telephone_number": "559-433-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALCOZIE",
        "first_name": "ABDUL KHALIQ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A191705",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A191705",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.