Individual provider Active NPI

Adam Michael Danielson

  • Internal Medicine Physician
  • Fresno, CA
National Provider Identifier
1811269806
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A156635 Issued in CA
Practice address
1303 E Herndon Ave
Fresno, CA 93720-3309
Phone
(559) 450-5672
NPI assigned
Feb 6, 2012
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A156635 CA Primary

Addresses

Primary practice location

1303 E Herndon Ave
Fresno, CA 93720-3309

Mailing address

1321 Orleans St
Apt 2210
Detroit, MI 48207-2908
Phone (313) 404-5040

Other practice location 1

620 John Paul Jones Cir
Naval Medical Center Portsmouth
Portsmouth, VA 23708-2111
Phone (757) 953-3149

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
I20190422001595 CA Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Emergency Medicine 9739421892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Wayne State University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Agnes Medical FoundationGroup PAC ID 7618946369, 161 clinicians

Practice addresses (Care Compare)

1221 E Spruce Ave
Fresno, CA 93720-3374
Phone (559) 450-5777

1303 E Herndon Ave
Fresno, CA 93720-3309
Phone (559) 450-3433

1379 E Herndon Ave
Fresno, CA 93720-3309
Phone (559) 450-6388

Hospital & facility affiliations

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 Medicine

State licenses

LicenseStateTypeSpecialty
A156635CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LQMG Medical Group Inc. Internal Medicine Current Accepting new patients
Saint Agnes Medical Foundation Internal Medicine CurrentSince Jul 18, 2022 Accepting new patients

Locations

1111 E Spruce Ave
Ste 431
Fresno, CA 93720
Phone (559) 450-5611

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

1303 E Herndon Ave
Fresno, CA 93720
Phone (559) 449-3000

Interoperability endpoints

  • Direct secure messaging: adanielson2712622@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1328486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1811269806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 ORLEANS ST",
            "address_2": "APT 2210",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072908",
            "telephone_number": "313-404-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203309",
            "telephone_number": "559-450-5672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 John Paul Jones Cir",
            "address_2": "Naval Medical Center Portsmouth",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082111",
            "country_code": "US",
            "telephone_number": "757-953-3149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIELSON",
        "first_name": "ADAM",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-06",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A156635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.