Individual provider Active NPI

Yevgeniya Bagdasarova, PA-C

  • Physician Assistant
  • Fresno, CA
National Provider Identifier
1699701102
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15617 Issued in CA
Practice address
3248 E. Shields Ave
Suite D
Fresno, CA 93726
Phone
(559) 233-3343
Fax
(559) 233-3350
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15617 CA Primary

Addresses

Primary practice location

3248 E. Shields Ave
Suite D
Fresno, CA 93726

Mailing address

3248 E Shields Ave
Ste D
Fresno, CA 93726-6915
Phone (559) 233-3343

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040525000548 CA Practitioner - Physician Assistant 5294716577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Todos Para la SaludGroup PAC ID 1951673748, 9 clinicians

Practice addresses (Care Compare)

3830 N 1St St
Fresno, CA 93726-2328

4420 N 1St St
Suite 123
Fresno, CA 93726-2328
Phone (559) 231-5366

Hospital & facility affiliations

  • Compassionate Care Home Health Agency, LLC Home health agency, Fresno, CA, CCN 058233
  • Saint Agnes Home Health and Hospice Home health agency, Fresno, CA, CCN 057135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Todos Para la Salud CurrentSince Mar 1, 2021 Accepting new patients
Carlos L. Cordoba M.D. Inc. Past Accepting new patients

Locations

4420 N 1st St
Ste 123
Fresno, CA 93726
Phone (559) 231-5366

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCGBCD

Organizations & group practices 3

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1699701102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3248 E SHIELDS AVE",
            "address_2": "STE D",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937266915",
            "telephone_number": "559-233-3343",
            "fax_number": "559-233-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3248 E. SHIELDS AVE",
            "address_2": "SUITE D",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93726",
            "telephone_number": "559-233-3343",
            "fax_number": "559-233-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGDASAROVA",
        "first_name": "YEVGENIYA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "15617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.