Individual provider Active NPI

Nicole Ann Shlimun, D.O.

  • Internal Medicine Physician
  • Fresno, CA
National Provider Identifier
1487219242
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A20131 Issued in CA
Practice address
1221 E Spruce Ave
Fresno, CA 93720
Phone
(559) 450-5777
NPI assigned
May 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 20A20131 CA Primary

Addresses

Primary practice location

1221 E Spruce Ave
Fresno, CA 93720

Mailing address

1221 E Spruce Ave
Fresno, CA 93720
Phone (315) 416-2922

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
I20230109000294 CA Practitioner - Internal Medicine 9537539580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Nova Southeastern College of Osteo Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Agnes Medical FoundationGroup PAC ID 7618946369, 161 clinicians

Practice addresses (Care Compare)

1221 E Spruce Ave
Fresno, CA 93720-3374
Phone (559) 450-5777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.57 of 100Reported as group
Quality
63.43
Promoting interoperability
98
Improvement activities
40
Cost
77.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A20131CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LQMG Medical Group Inc. Single Specialty Current Accepting new patients
Saint Agnes Medical Foundation Single Specialty CurrentSince Oct 3, 2022 Accepting new patients

Locations

1111 E Spruce Ave
Ste 431
Fresno, CA 93720
Phone (559) 450-5611

1221 E Spruce Ave
Fresno, CA 93720
Phone (559) 449-5777

Interoperability endpoints

  • Direct secure messaging: nolson2717272@direct.trinity-health.org
  • Direct secure messaging: nicoleolson1993@hiemail.healtheconnections.org

Organizations & group practices 2

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": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1487219242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 E SPRUCE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "315-416-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E SPRUCE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "559-450-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHLIMUN",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A20131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.