Individual provider Active NPI

Donald A Poladian, D.C.

  • Chiropractor
  • Fresno, CA
National Provider Identifier
1336295401
Registry record updated Nov 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CA11501 Issued in CA
Practice address
488 W Shaw Ave
Fresno, CA 93704-2511
Phone
(559) 227-0995
Fax
(559) 227-0904
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CA11501 CA Primary

Addresses

Primary practice location

488 W Shaw Ave
Fresno, CA 93704-2511

Mailing address

488 W Shaw Ave
Fresno, CA 93704-2511
Phone (559) 227-0995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040413000659 CA Practitioner - Chiropractic 0941294979 Reassigns benefits to 1 organization
Practice locations: Madera, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westside Medical Group IncGroup PAC ID 8921176272, 2 clinicians

Practice addresses (Care Compare)

1107 O St
Firebaugh, CA 93622-2224
Phone (559) 659-9000

488 W Shaw Ave
Fresno, CA 93704-2511
Phone (559) 227-0995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11501CAMDMental Health Counselor
CA11501CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Medical Group of Mendota Inc. CurrentSince Jun 27, 2005 Accepting new patients
Poladian Chiropractic Corporation Chiropractor CurrentSince May 1, 1976 Accepting new patients
Westside Medical Group Inc Past Accepting new patients

Locations

488 W Shaw Ave
Fresno, CA 93704
Phone (559) 227-0695

501 W Yosemite Ave
Madera, CA 93637
Phone (559) 675-1211

Organizations & group practices 3

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290816000000",
    "number": "1336295401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 W SHAW AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937042511",
            "telephone_number": "559-227-0995",
            "fax_number": "559-227-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 W SHAW AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937042511",
            "telephone_number": "559-227-0995",
            "fax_number": "559-227-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLADIAN",
        "first_name": "DONALD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2010-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "CA11501",
            "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 Nov 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.