NPIMap

Individual provider Active NPI

Desmond Paul-Coker, D.O.

  • Internal Medicine Physician
  • Fresno, CA
National Provider Identifier
1720340805
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A13835 Issued in CA
Practice address
4770 W Herndon Ave Ste 107
Fresno, CA 93722-8401
Phone
(559) 450-6310
Fax
(559) 450-6311
NPI assigned
Jun 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OT014864 PA
Internal Medicine Physician 207R00000X 20A13835 CA Primary

Addresses

Primary practice location

4770 W Herndon Ave Ste 107
Fresno, CA 93722-8401

Mailing address

1303 E Herndon Ave
Suite 431
Fresno, CA 93720-3309
Phone (559) 450-3889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151029001604 CA Practitioner - Internal Medicine 7618286899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Agnes Medical FoundationGroup PAC ID 7618946369, 161 clinicians

Practice addresses (Care Compare)

4770 W Herndon Ave
Suite 107
Fresno, CA 93722-8401
Phone (559) 450-6310

Hospital & facility affiliations

  • Saint Agnes Home Health and Hospice Home health agency, Fresno, CA, CCN 057135
  • Compassionate Care Home Health Agency, LLC Home health agency, Fresno, CA, CCN 058233
  • Community Home Care Home health agency, Fresno, CA, CCN 057248
  • St Mary'S Home Health Services, Inc Home health agency, Fresno, CA, CCN 058195
  • Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093
  • San Joaquin Valley Rehabilitation Hosp Inpatient rehabilitation facility, Fresno, CA, CCN 053032

Merit-based Incentive Payment System (MIPS)

Final score
85.57 of 100Reported as group
Quality
63.43
Promoting interoperability
98
Improvement activities
40
Cost
77.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A13835CAMDInternal Medicine Physician
OT014864PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LQMG Medical Group Inc. Internal Medicine Current Accepting new patients
Saint Agnes Medical Foundation Internal Medicine CurrentSince Jan 1, 2017 Accepting new patients
Saint Agnes Medical Center Past Accepting new patients

Locations

4770 W Herndon Ave
Ste 107
Fresno, CA 93722
Phone (559) 450-6310

1221 E Spruce Ave
Fresno, CA 93720
Phone (559) 449-5777

1377 E Herndon Ave
Ste 104
Fresno, CA 93720
Phone (559) 450-7455

1303 E Herndon Ave
Ste 431
Fresno, CA 93720

4770 W Herndon Ave
#107
Fresno, CA 93722

Interoperability endpoints

  • Direct secure messaging: dpaulcoker2714268@direct.trinity-health.org

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 6

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": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1720340805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 E HERNDON AVE",
            "address_2": "SUITE 431",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203309",
            "telephone_number": "559-450-3889",
            "fax_number": "559-450-7473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 W HERNDON AVE STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937228401",
            "telephone_number": "559-450-6310",
            "fax_number": "559-450-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL-COKER",
        "first_name": "DESMOND",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-13",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT014864",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A13835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.