Active NPI
Judy Miramontes, M.D.
- Family Medicine Physician
- Clovis, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G80495
- Practice address
- 275 W Herndon Ave
Clovis, CA 93612-0204 - Phone
- (559) 324-6200
- Fax
- (559) 324-6280
- NPI assigned
- Nov 8, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G80495 | CA | Primary |
| Obstetrics & Gynecology Physician | 207V00000X | G80495 | CA |
Addresses
Primary practice location
275 W Herndon Ave
Clovis, CA 93612-0204
Mailing address
PO Box 28949
Fresno, CA 93729-8949
Phone (559) 228-4200
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080085527 | Other | CA | RAILROAD MEDICARE |
| 00G804950 | Other | CA | BLUE CROSS/BLUE SHIELD |
| 00G804950 | Medicaid | CA | |
| 77040368493612B012 | Other | CA | CHAMPUS |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
275 W Herndon Ave
Clovis, CA 93612-0204
Phone (559) 324-6200
Hospital & facility affiliations
- Clovis Community Medical Center
- Community Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G80495 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Foundation Medical Group | Current | Accepting new patients | |
| Community Foundation Medical Group | Current | Accepting new patients | |
| Community Foundation Medical Group | Family Medicine | Current | Accepting new patients |
| Fresno Community Hospital and Medical Center | Past | Accepting new patients | |
| Valley Children'S Hospital | Past | Accepting new patients |
Locations
275 W Herndon Ave
Clovis, CA 93612
Phone (559) 321-4255
2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Fresno, CA
- NPI 1811258510
-
- Orthopaedic Surgery Physician
- Fresno, CA
- NPI 1134668353
Family Medicine
-
- Orthopaedic Surgery Physician
- Fresno, CA
- NPI 1376056721
-
- General Acute Care Hospital
- Fresno, CA
- NPI 1104906569
-
- Children's Hospital
- Madera, CA
- NPI 1952312043
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fresno, CA
- NPI 1104906569
-
- General Acute Care Hospital
- Clovis, CA
- NPI 1316027709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582588800000",
"number": "1477534345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 28949",
"city": "FRESNO",
"state": "CA",
"postal_code": "937298949",
"telephone_number": "559-228-4200",
"fax_number": "559-224-3920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 W HERNDON AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936120204",
"telephone_number": "559-324-6200",
"fax_number": "559-324-6280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRAMONTES",
"first_name": "JUDY",
"name_prefix": "Ms.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-08",
"last_updated": "2020-02-25",
"certification_date": "2020-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G80495",
"primary": true
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CA",
"license": "G80495",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080085527",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "00G804950",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G804950",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "77040368493612B012",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.