Individual provider Active NPI

Ivance E Pugoy, M.D.

  • Internal Medicine Physician
  • Fresno, CA
National Provider Identifier
1902109382
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
115030 Issued in CA
Practice address
155 N Fresno St
Fresno, CA 93701-2302
Phone
(559) 499-6400
NPI assigned
Dec 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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 115030 CA Primary

Addresses

Primary practice location

155 N Fresno St
Fresno, CA 93701-2302

Mailing address

155 N Fresno St
Fresno, CA 93701-2302
Phone (559) 499-6500

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
I20131220000029 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1951538875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1902109382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012302",
            "telephone_number": "559-499-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012302",
            "telephone_number": "559-499-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGOY",
        "first_name": "IVANCE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-07",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "115030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.