Individual provider Active NPI

Nikolay Dimitrov, M.D.

  • Psychiatry Physician
  • Fresno, CA
National Provider Identifier
1427412337
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A151029 Issued in CA
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

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
A151029CAMDPsychiatry 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.

Verify at the official NPI Registry.