Individual provider Active NPI

Jeanett Segal, MD

  • Allergy Physician
  • Fresno, CA
National Provider Identifier
1619916913
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
A81422 Issued in CA
Practice address
6700 N 1St St
Ste 131
Fresno, CA 93710-3947
Phone
(714) 633-4666
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X A81422 CA Primary
Dermatology Physician 207N00000X A81422 CA

Addresses

Primary practice location

6700 N 1St St
Ste 131
Fresno, CA 93710-3947

Mailing address

44215 15TH St W
Ste 209
Lancaster, CA 93534-5504
Phone (310) 348-0500

Other identifiers 1

IdentifierTypeStateIssuer
WA81422AOtherCAPPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031201000844 CA Practitioner - DermatologyPractitioner - Allergy/Immunology 1456256676 Reassigns benefits to 1 organization
I20120119000313 FL Practitioner - DermatologyPractitioner - General PracticePractitioner - Allergy/Immunology 1456256676 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Csi Medical Group Dermatology CurrentSince Jan 3, 2017 Accepting new patients
Barnett Dermatology PA Dermatology CurrentSince Sep 1, 2024 Accepting new patients
Carlsbad and Vista Dermatology, Inc. Dermatology PastSince Jul 1, 2017 Accepting new patients
J. Robert West, M.D., Inc Dermatology Past Accepting new patients
Wall Medical Group Dermatology Past Accepting new patients

Locations

4201 Torrance Blvd
Ste 640
Torrance, CA 90503
Phone (310) 375-9994

1934 Via Ctr
Ste B
Vista, CA 92081
Phone (760) 295-2299

7100 Camino Real
Ste 207
Boca Raton, FL 33433
Phone (561) 391-2770

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1619916913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44215 15TH ST W",
            "address_2": "STE 209",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935345504",
            "telephone_number": "310-348-0500",
            "fax_number": "310-348-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 N 1ST ST",
            "address_2": "STE 131",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937103947",
            "telephone_number": "714-633-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGAL",
        "first_name": "JEANETT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": "A81422",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A81422",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPIN",
            "identifier": "WA81422A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.