Individual provider Active NPI

Corinne E Frugoni, MD

  • Family Medicine Physician
  • Eureka, CA
National Provider Identifier
1639177892
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G70478 Issued in CA
Practice address
2440 23Rd St
Eureka, CA 95501-3203
Phone
(707) 298-2011
Fax
(707) 502-3617
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G70478 CA Primary

Addresses

Primary practice location

2440 23Rd St
Eureka, CA 95501-3203

Mailing address

2440 23Rd St
Eureka, CA 95501-3203
Phone (707) 298-2011

Other identifiers 1

IdentifierTypeStateIssuer
00G704781MedicaidCA

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
I20101130001403 CA Practitioner - Family Practice 1658567763 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G70478CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of Humboldt Inc Family Medicine CurrentSince Sep 1, 2024 Accepting new patients
United Indian Health Services, Inc. Past Accepting new patients

Locations

3327 Timber Fall Ct
Eureka, CA 95503
Phone (707) 445-8443

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.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1639177892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 23RD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013203",
            "telephone_number": "707-298-2011",
            "fax_number": "707-502-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 23RD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013203",
            "telephone_number": "707-298-2011",
            "fax_number": "707-502-3617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUGONI",
        "first_name": "CORINNE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G70478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G704781",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.