NPIMap

Organization Active NPI

University Faculty Associates , Inc.

  • Vascular Surgery Physician
  • Fresno, CA
National Provider Identifier
1881092963
Registry record updated Sep 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
UNIVERSITY FACULTY ASSOCIATES , INC.
Practice address
1247 E Alluvial Ave
Suite 101
Fresno, CA 93720-2686
Phone
(559) 431-6226
Fax
(559) 440-9005
NPI assigned
Dec 5, 2014
Last updated
Sep 4, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY FACULTY ASSOCIATES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 4, 2015

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

Authorized official

Name
Dr. Randall Gordon Stern, MDNPI 1962512319
Title
President
Phone
(559) 443-2682

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X NU Primary
Podiatrist 213E00000X NU

Addresses

Primary practice location

1247 E Alluvial Ave
Suite 101
Fresno, CA 93720-2686

Mailing address

2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 443-2682

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150211000164 CA Part B Supplier - Clinic/Group Practice 6507181708 Receives reassigned benefits from 364 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Selma, CA; Fresno, CA; Clovis, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
University Faculty Assoc

Locations

1247 E Alluvial Ave
Fresno, CA 93720
Phone (559) 370-8694

2335 E Kashian Ln
Ste 240
Fresno, CA 93701
Phone (559) 320-0545

2335 E Kashian Ln
Ste 280
Fresno, CA 93701
Phone (559) 256-5130

6215 N Fresno St
Ste 103
Fresno, CA 93710
Phone (559) 431-6226

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 118

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 118

NPI Registry JSON

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

{
    "created_epoch": "1417737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441324800000",
    "number": "1881092963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431",
            "telephone_number": "559-443-2682",
            "fax_number": "559-443-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 E ALLUVIAL AVE",
            "address_2": "SUITE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202686",
            "telephone_number": "559-431-6226",
            "fax_number": "559-440-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY FACULTY ASSOCIATES , INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY FACULTY ASSOCIATES, INC.",
        "enumeration_date": "2014-12-05",
        "last_updated": "2015-09-04",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-443-2682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Sep 4, 2015; 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.