NPIMap

Organization Active NPI

Edgar S. Macias, M.D., Inc

  • Dermatology Physician
  • Fresno, CA
National Provider Identifier
1871882712
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A112259 Issued in CA
Legal business name
EDGAR S. MACIAS, M.D., INC
Practice address
7115 N Chestnut Ave Ste 101
Fresno, CA 93720-0361
Phone
(559) 431-2397
Fax
(559) 472-3382
NPI assigned
Mar 31, 2011
Last updated
Jun 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Authorized official

Name
Vanessa Canez
Title
Office Manager
Phone
(559) 431-2397

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A112259 CA Primary
Non-Pharmacy Dispensing Site 332900000X

Addresses

Primary practice location

7115 N Chestnut Ave Ste 101
Fresno, CA 93720-0361

Mailing address

7115 N Chestnut Ave Ste 101
Fresno, CA 93720-0361
Phone (559) 431-2397

Other identifiers 1

IdentifierTypeStateIssuer
1144482373OtherINIVIDUAL NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110926000541 CA Part B Supplier - Clinic/Group Practice 2567630551 Receives reassigned benefits from 16 practitioners
Practice locations: Fresno, CA; Hanford, CA

National Provider Directory

National Provider Directory

Locations

1290 E Spruce Ave
Ste 101
Fresno, CA 93720
Phone (559) 431-2397

7115 N Chestnut Ave
Fresno, CA 93720

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559779200000",
    "number": "1871882712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7115 N CHESTNUT AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937200361",
            "telephone_number": "559-431-2397",
            "fax_number": "559-472-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7115 N CHESTNUT AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937200361",
            "telephone_number": "559-431-2397",
            "fax_number": "559-472-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGAR S. MACIAS, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-31",
        "last_updated": "2019-06-06",
        "status": "A",
        "authorized_official_last_name": "CANEZ",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "559-431-2397"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A112259",
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INIVIDUAL NPI",
            "identifier": "1144482373",
            "state": null
        }
    ],
    "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 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.