Individual provider Active NPI

Frank Edward Fine, MD

  • General Practice Physician
  • Modesto, CA
National Provider Identifier
1700981016
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A0066472 Issued in CA
Practice address
803 Coffee Rd
Suite 4
Modesto, CA 95355-4227
Phone
(209) 569-0776
Fax
(209) 569-0778
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A0066472 CA Primary

Addresses

Primary practice location

803 Coffee Rd
Suite 4
Modesto, CA 95355-4227

Mailing address

803 Coffee Rd
Suite 4
Modesto, CA 95355-4227
Phone (209) 569-0776

Other identifiers 1

IdentifierTypeStateIssuer
0896337MedicaidCA

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
I20111205000412 CA Practitioner - General PracticePractitioner - Pain Management 7315112224 Practice locations: Modesto, CA

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Pain Management
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

803 Coffee Rd
Suite 4
Modesto, CA 95355-4238
Phone (209) 569-0776

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A0066472CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Valley Hospital District Past Accepting new patients
Frank Fine, MD Past Accepting new patients

Organizations & group practices 2

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700981016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 COFFEE RD",
            "address_2": "SUITE 4",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554227",
            "telephone_number": "209-569-0776",
            "fax_number": "209-569-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 COFFEE RD",
            "address_2": "SUITE 4",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554227",
            "telephone_number": "209-569-0776",
            "fax_number": "209-569-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINE",
        "first_name": "FRANK",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A0066472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0896337",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.