Individual provider Active NPI

Rendoll Concepcion, MD

  • Surgery Physician
  • Fresno, CA
National Provider Identifier
1669498655
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A39752 Issued in CA
Practice address
1885 E Alluvial
#101
Fresno, CA 93710
Phone
(559) 298-9031
Fax
(559) 298-9061
NPI assigned
Jul 14, 2006
Last updated
Feb 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A39752 CA Primary

Addresses

Primary practice location

1885 E Alluvial
#101
Fresno, CA 93710

Mailing address

1855 E Alluvial Ave
Ste 103
Fresno, CA 93720-3854
Phone (559) 253-2800

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
I20060928000286 CA Practitioner - General SurgeryPractitioner - Thoracic SurgeryPractitioner - Surgical Oncology 7911902838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Surgical Oncology, Thoracic Surgery
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1855 E Alluvial Ave
Suite 103
Fresno, CA 93720-3854
Phone (559) 298-3032

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)16
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A39752CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rendoll Concepcion M.D, Inc Surgery CurrentSince Aug 7, 2006 Accepting new patients
Jose U. Zamora, II, M.D., a Medical Corporation Surgery PastSince Dec 11, 2019 Accepting new patients
North Point Surgery Center, Inc Past Accepting new patients
Saint Agnes Medical Center Past Accepting new patients

Locations

1885 E Alluvial Ave
Ste 101
Fresno, CA 93720
Phone (559) 298-9032

1855 E Alluvial Ave
Ste 103
Fresno, CA 93720
Phone (559) 253-2800

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1669498655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 E ALLUVIAL AVE",
            "address_2": "STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203854",
            "telephone_number": "559-253-2800",
            "fax_number": "559-298-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 E ALLUVIAL",
            "address_2": "#101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93710",
            "telephone_number": "559-298-9031",
            "fax_number": "559-298-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCEPCION",
        "first_name": "RENDOLL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A39752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.