Active NPI
Conall McCabe
- Family Medicine Physician
- Fresno, CA
National Provider Identifier
1790893329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G59261
- Practice address
- 290 N Wayte LN
Fresno, CA 93701-2124 - Phone
- (559) 459-5700
- Fax
- (559) 459-4443
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G59261 | CA | Primary |
Addresses
Primary practice location
290 N Wayte LN
Fresno, CA 93701-2124
Mailing address
4910 E Clinton Way
Suite 101
Fresno, CA 93727-1560
Phone (559) 443-2682
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G592610 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| G59261 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central California Faculty Medical Group, Inc. | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Clovis, CA
- NPI 1992742852
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308787200000",
"number": "1790893329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4910 E CLINTON WAY",
"address_2": "SUITE 101",
"city": "FRESNO",
"state": "CA",
"postal_code": "937271560",
"telephone_number": "559-443-2682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 N WAYTE LN",
"city": "FRESNO",
"state": "CA",
"postal_code": "937012124",
"telephone_number": "559-459-5700",
"fax_number": "559-459-4443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCABE",
"first_name": "CONALL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2011-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G59261",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G592610",
"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 Jun 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.