NPIMap

Individual provider Active NPI

Yenifer Duque-Gomez, PA-C

  • Physician Assistant
  • Fresno, CA
National Provider Identifier
1891147286
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA53528 Issued in CA
Practice address
3645 W Shaw Ave Ste 101
Fresno, CA 93711-3206
Phone
(559) 457-6800
Fax
(559) 457-6890
NPI assigned
Jul 8, 2016
Last updated
Sep 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA53528 CA Primary

Addresses

Primary practice location

3645 W Shaw Ave Ste 101
Fresno, CA 93711-3206

Mailing address

3645 W Shaw Ave Ste 101
Fresno, CA 93711-3206
Phone (559) 457-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161013002576 CA Practitioner - Physician Assistant 0042508616 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northbay Health Medical FoundationGroup PAC ID 3274010871, 207 clinicians

Practice addresses (Care Compare)

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone (707) 429-3600

1860 Pennsylvania Ave
Fairfield, CA 94533-3590
Phone (707) 646-4114

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA53528CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network CurrentSince Sep 12, 2016 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Altura Centers for Health CurrentSince Feb 1, 2018 Accepting new patients
Altura Centers for Health CurrentSince Feb 1, 2018 Accepting new patients
Northbay Health Medical Foundation CurrentSince Jan 1, 2026 Accepting new patients
Northbay Healthcare Group CurrentSince Jul 1, 2021 Accepting new patients
Family Healthcare Network CurrentSince Sep 12, 2016 Accepting new patients
Family Healthcare Network Current Accepting new patients

Locations

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

1860 Pennsylvania Ave
Ste 110
Fairfield, CA 94533
Phone (707) 254-9693

1860 Pennsylvania Ave
Ste 300
Fairfield, CA 94533
Phone (707) 438-2735

1101 N Cherry St
Tulare, CA 93274
Phone (559) 685-4601

1134 E Cartmill Ave
Tulare, CA 93274
Phone (559) 786-4993

1010 Nut Tree Rd
Ste 100B
Vacaville, CA 95687
Phone (707) 646-7999

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

400 E Oak Ave
Visalia, CA 93291
Phone (559) 741-4500

101 Main St
Winters, CA 95694
Phone (530) 795-4123

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCECCA
  • Direct secure messaging: yenifer.duquegomez.p1@direct.altura.nextgenshare.com

Organizations & group practices 14

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.

View all 14

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": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1891147286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 W SHAW AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113206",
            "telephone_number": "559-457-6800",
            "fax_number": "559-457-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 W SHAW AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113206",
            "telephone_number": "559-457-6800",
            "fax_number": "559-457-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUQUE-GOMEZ",
        "first_name": "YENIFER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA53528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.