Individual provider Active NPI

Michele Meime Maison-Fomotar, MD

  • Infectious Disease Physician
  • Fresno, CA
National Provider Identifier
1407210453
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
A160693 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 6, 2016
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 A160693 CA
Infectious Disease Physician 207RI0200X A160693 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 names 1

  • Michele Maison Meime Former name

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
I20210810002449 CA Practitioner - Infectious DiseasePractitioner - Internal Medicine 3274937446 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2010
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A160693CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LQMG Medical Group Inc. Internal Medicine Current Accepting new patients
Central California Faculty Medical Group, Inc. Internal Medicine CurrentSince Dec 1, 2024 Accepting new patients
University Faculty Associates, Inc. Internal Medicine CurrentSince Sep 1, 2021 Accepting new patients
Saint Agnes Medical Foundation Internal Medicine CurrentSince Nov 1, 2021 Accepting new patients
Central California Faculty Medical Group, Inc. Current Accepting new patients
Body and Mind Healthcare Services - a Nursing Corporation Past Accepting new patients
United Health Centers of the San Joaquin Valley Past Accepting new patients

Locations

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

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

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

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

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

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

155 N Fresno St
Fresno, CA 93701
Phone (559) 499-6440

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

Interoperability endpoints

  • Direct secure messaging: michele.maison.fomotar.1@31788.direct.athenahealth.com
  • Direct secure messaging: michele.maison-fomotar.1@17661.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 2

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": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1407210453",
    "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": "MAISON-FOMOTAR",
        "first_name": "MICHELE",
        "middle_name": "MEIME",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A160693",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "A160693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "MAISON MEIME",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.