Individual provider Active NPI

Carolina Quezada, MD

  • Internal Medicine Physician
  • Woodlake, CA
National Provider Identifier
1649502022
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A111051 Issued in CA
Practice address
201 East Lakeview Ave.
Woodlake, CA 93286-1422
Phone
(559) 564-0100
Fax
(559) 564-2285
NPI assigned
Feb 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A111051 CA Primary
Pediatrics Physician 208000000X A111051 CA

Addresses

Primary practice location

201 East Lakeview Ave.
Woodlake, CA 93286-1422

Mailing address

305 East Center Ave.
Visalia, CA 93291-6331
Phone (559) 737-4700

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
I20121008000277 CA Practitioner - Family Practice 0345499323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Healthcare NetworkGroup PAC ID 6305756339, 91 clinicians

Practice addresses (Care Compare)

201 E Lakeview Ave
Woodlake, CA 93286-1301
Phone (559) 564-0100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A111051CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare Network CurrentSince Sep 4, 2012 Accepting new patients
Family Healthcare Network CurrentSince Sep 4, 2012 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Kaweah Delta Health Care District Past Accepting new patients
Family Healthcare Network Past Accepting new patients

Locations

33025 Road 159
Ivanhoe, CA 93235
Phone (559) 798-1877

2333 S Mooney Blvd
Visalia, CA 93277
Phone (559) 205-1800

400 E Oak Ave
Visalia, CA 93291
Phone (559) 741-4500

501 N Bridge St
Visalia, CA 93291
Phone (559) 734-1939

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

201 E Lakeview Ave
Woodlake, CA 93286
Phone (559) 564-0100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCECCA
  • Direct secure messaging: carolina.quezada@fhcn.eclinicaldirectplus.com

Organizations & group practices 9

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": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375142400000",
    "number": "1649502022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 EAST CENTER AVE.",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916331",
            "telephone_number": "559-737-4700",
            "fax_number": "559-737-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 EAST LAKEVIEW AVE.",
            "city": "WOODLAKE",
            "state": "CA",
            "postal_code": "932861422",
            "telephone_number": "559-564-0100",
            "fax_number": "559-564-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEZADA",
        "first_name": "CAROLINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-09",
        "last_updated": "2013-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A111051",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A111051",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodlake, CA

Sources for this page

Verify at the official NPI Registry.