Individual provider Active NPI

Samuel Feliciano Morales, PA-C

  • Physician Assistant
  • Fresno, CA
National Provider Identifier
1912216995
Registry record updated Aug 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21200 Issued in CA
Practice address
2505 Merced St
Fresno, CA 93721-1811
Phone
(559) 445-0391
NPI assigned
Sep 24, 2010
Last updated
Aug 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2018

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 PA21200 CA Primary

Addresses

Primary practice location

2505 Merced St
Fresno, CA 93721-1811

Mailing address

1350 O St Ste 302
Fresno, CA 93721-1828
Phone (559) 369-4625

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
I20180215000912 CA Practitioner - Physician Assistant 5294095097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omni Family HealthGroup PAC ID 9234176363, 93 clinicians

Practice addresses (Care Compare)

2505 Merced St
Fresno, CA 93721-1811
Phone (866) 707-6664

925 G St
Reedley, CA 93654-2626
Phone (866) 707-6664

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA21200CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Family Health CurrentSince Feb 19, 2018 Accepting new patients
Omni Family Health CurrentSince Feb 19, 2018 Accepting new patients
Saint Agnes Medical Center Past Accepting new patients
Omni Family Health PastSince Dec 1, 2020 Accepting new patients
Omni Family Health Past Accepting new patients
Power Mental Health Services Inc PastSince Jan 7, 2024 Accepting new patients

Locations

4900 California Ave
Ste 400B
Bakersfield, CA 93309
Phone (661) 630-7046

277 E Front St
Buttonwillow, CA 93206
Phone (661) 630-7381

2505 Merced St
Fresno, CA 93721
Phone (559) 369-4625

925 G St
Reedley, CA 93654
Phone (559) 558-9712

Interoperability endpoints

  • Direct secure messaging: samuel.morales.p1@direct.omnifamilyhealth.nextgenshare.com

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533859200000",
    "number": "1912216995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 O ST STE 302",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211828",
            "telephone_number": "559-369-4625",
            "fax_number": "559-369-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 MERCED ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211811",
            "telephone_number": "559-445-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "SAMUEL",
        "middle_name": "FELICIANO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-24",
        "last_updated": "2018-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.