Individual provider Active NPI

Hedieh Stefanacci

  • Plastic Surgery Physician
  • Fresno, CA
National Provider Identifier
1770693178
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
G81489 Issued in CA
Practice address
2365 E Fir Ave
Fresno, CA 93720-8016
Phone
(559) 797-9000
Fax
(559) 797-9005
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X G81489 CA Primary

Addresses

Primary practice location

2365 E Fir Ave
Fresno, CA 93720-8016

Mailing address

2365 E Fir Ave
Fresno, CA 93720-8016
Phone (559) 797-9000

Other identifiers 1

IdentifierTypeStateIssuer
00G814890MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G81489CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stefanacci Medical Corporation Plastic Surgery CurrentSince May 25, 2009 Accepting new patients
Central California Faculty Medical Group, Inc. Past Accepting new patients

Locations

2365 E Fir Ave
Fresno, CA 93720
Phone (559) 797-9000

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1770693178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 E FIR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208016",
            "telephone_number": "559-797-9000",
            "fax_number": "559-797-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 E FIR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208016",
            "telephone_number": "559-797-9000",
            "fax_number": "559-797-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANACCI",
        "first_name": "HEDIEH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G81489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G814890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.