NPIMap

Organization Active NPI

Eye Medical Clinic of Fresno, Inc.

  • Ophthalmology Physician
  • Fresno, CA
National Provider Identifier
1659388700
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE MEDICAL CLINIC OF FRESNO, INC.
Practice address
1122 S Street
Fresno, CA 93721
Phone
(559) 449-5097
Fax
(559) 439-6804
NPI assigned
Aug 2, 2006
Last updated
May 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2012

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

Authorized official

Name
Denise Haar
Title
Administrator
Phone
(559) 449-5097

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

1122 S Street
Fresno, CA 93721

Mailing address

1122 S Street
Fresno, CA 93721
Phone (559) 449-5097

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ49159ZMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050504001241 CA Part B Supplier - Clinic/Group Practice 1355381740 Receives reassigned benefits from 29 practitioners
1 other NPI on this enrollment
Practice locations: Fresno, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337299200000",
    "number": "1659388700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 S STREET",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93721",
            "telephone_number": "559-449-5097",
            "fax_number": "559-439-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 S STREET",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93721",
            "telephone_number": "559-449-5097",
            "fax_number": "559-439-6804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE MEDICAL CLINIC OF FRESNO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2012-05-18",
        "status": "A",
        "authorized_official_last_name": "HAAR",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "559-449-5097"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ49159Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.