Active NPI
Nikolay Dimitrov, M.D.
- Psychiatry Physician
- Fresno, CA
National Provider Identifier
1427412337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A151029
- Practice address
- 2615 E Clinton Ave
Fresno, CA 93703-2223 - Phone
- (559) 225-6100
- NPI assigned
- Apr 6, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A151029 | CA | Primary |
Addresses
Primary practice location
2615 E Clinton Ave
Fresno, CA 93703-2223
Mailing address
155 N Fresno St
Fresno, CA 93701-2302
Other practice location 1
1060 W Sierra Ave Ste 105
Fresno, CA 93711-2063
Phone (559) 437-1111
Other practice location 2
155 N Fresno St
Fresno, CA 93701-2302
Phone (559) 499-6580
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A151029 | CA | MD | Psychiatry Physician |
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": "1595289600000",
"number": "1427412337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 N FRESNO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937012302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2615 E CLINTON AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937032223",
"telephone_number": "559-225-6100"
}
],
"practiceLocations": [
{
"address_1": "1060 W Sierra Ave Ste 105",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937112063",
"country_code": "US",
"telephone_number": "559-437-1111",
"fax_number": "559-437-1118",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "155 N Fresno St",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937012302",
"country_code": "US",
"telephone_number": "559-499-6580",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIMITROV",
"first_name": "NIKOLAY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-06",
"last_updated": "2020-07-21",
"certification_date": "2020-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A151029",
"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 Jul 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.