Individual provider Active NPI

Ferishta Gousse, M.D

  • Family Medicine Physician
  • Fresno, CA
National Provider Identifier
1679916019
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A149004 Issued in CA
Practice address
1945 N Fine Ave Ste 100
Fresno, CA 93727-1528
Phone
(559) 457-5650
Fax
(559) 457-5695
NPI assigned
Apr 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 54779 TN
Family Medicine Physician 207Q00000X A149004 CA Primary

Addresses

Primary practice location

1945 N Fine Ave Ste 100
Fresno, CA 93727-1528

Mailing address

1945 N Fine Ave Ste 100
Fresno, CA 93727-1528
Phone (559) 457-5650

Other practice location 1

1999 highway 51 south
suite # 1031
covington, TN 38019
Phone (901) 476-4457

Other names 1

  • Ferishta Nawabi Former name

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
I20170822001907 CA Practitioner - Family Practice 2264670942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinica Sierra VistaGroup PAC ID 3870407505, 180 clinicians

Practice addresses (Care Compare)

1350 S Orange Ave
Fresno, CA 93702-3463
Phone (559) 457-5400

1945 N Fine Ave
Fresno, CA 93727-1528

2505 E Divisadero St
Fresno, CA 93721-1401
Phone (559) 457-5500

2740 S Elm Ave
Fresno, CA 93706-5435
Phone (559) 457-5200

2760 S Elm Ave
Fresno, CA 93706-5435
Phone (559) 457-5300

Hospital & facility affiliations

  • Community Home Care Home health agency, Fresno, CA, CCN 057248
  • Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A149004CAMDFamily Medicine Physician
54779TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Sierra Vista CurrentSince Aug 9, 2017 Accepting new patients
Clinica Sierra Vista Current Accepting new patients
Clinica Sierra Vista CurrentSince Aug 9, 2017 Accepting new patients
Clinica Sierra Vista Past Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients

Locations

2740 S Elm Ave
Fresno, CA 93706
Phone (559) 457-5200

1945 N Fine Ave
Ste 100
Fresno, CA 93727
Phone (559) 457-5650

2760 S Elm Ave
Fresno, CA 93706
Phone (559) 457-5300

1350 S Orange Ave
Fresno, CA 93702
Phone (559) 457-5400

Interoperability endpoints

  • Direct secure messaging: fgousse19112@clinicasierravista.direct-ci.com

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.

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": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679916019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 N FINE AVE STE 100",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937271528",
            "telephone_number": "559-457-5650",
            "fax_number": "559-457-5695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 N FINE AVE STE 100",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937271528",
            "telephone_number": "559-457-5650",
            "fax_number": "559-457-5695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1999 highway 51 south",
            "address_2": "suite # 1031",
            "address_purpose": "LOCATION",
            "city": "covington",
            "state": "TN",
            "postal_code": "38019",
            "country_code": "US",
            "telephone_number": "901-476-4457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOUSSE",
        "first_name": "FERISHTA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "54779",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A149004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FERISHTA",
            "last_name": "NAWABI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.