Individual provider Active NPI

Patricia Marie Gresham, ANP

  • Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1912043407
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
13225 Issued in CA
Practice address
6733 N Willow Ave Ste 107
Fresno, CA 93710-5953
Phone
(559) 435-4700
Fax
(559) 298-7951
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 13225 CA Primary

Addresses

Primary practice location

6733 N Willow Ave Ste 107
Fresno, CA 93710-5953

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
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141003001827 CA Practitioner - Nurse Practitioner 5193717908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6733 N Willow Ave
Suite 107
Fresno, CA 93710-5953
Phone (559) 435-4700

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as group
Quality
76.71
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13225CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Faculty Associates, Inc. CurrentSince Apr 1, 2015 Accepting new patients
Central California Faculty Medical Group, Inc. Current Accepting new patients
University Faculty Associates, Inc. Past Accepting new patients
Chester County Cardiology Associates, P.C. PastSince Jul 1, 2008 Accepting new patients

Locations

2828 Fresno St
Ste 203
Fresno, CA 93721
Phone (559) 320-1090

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

2315 E Illinois Ave
Fresno, CA 93701
Phone (559) 459-4243

6733 N Willow Ave
Ste 107
Fresno, CA 93710
Phone (559) 435-4700

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

2335 E Kashian Ln
Ste 410
Fresno, CA 93701
Phone (559) 266-4100

2335 E Kashian Ln
Ste 260
Fresno, CA 93701
Phone (559) 256-5130

2625 E Divisadero St
Fresno, CA 93721
Phone (559) 453-5200

Interoperability endpoints

  • Direct secure messaging: patricia.gresham.1@31788.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1912043407",
    "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": "6733 N WILLOW AVE STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105953",
            "telephone_number": "559-435-4700",
            "fax_number": "559-298-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESHAM",
        "first_name": "PATRICIA",
        "middle_name": "MARIE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "13225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.