NPIMap

Organization Active NPI

Fogg Remington Eyecare, Inc.

  • Ophthalmology Physician
  • Fresno, CA
National Provider Identifier
1912960253
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
FOGG REMINGTON EYECARE, INC.
Practice address
3830 N 1St St
Fresno, CA 93726-4301
Phone
(559) 226-3971
Fax
(559) 241-0368
NPI assigned
Apr 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Authorized official

Name
Ms. Paula Pendley
Title
Credentialing
Phone
(559) 449-5011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

3830 N 1St St
Fresno, CA 93726-4301

Mailing address

1360 E Herndon Ave
401
Fresno, CA 93720-3326
Phone (559) 449-5010

Other identifiers 2

IdentifierTypeStateIssuer
1304310003OtherCACIGNA MEDICARE DMERC
GR0078920MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040423001093 CA Part B Supplier - Clinic/Group Practice 7911993902 Receives reassigned benefits from 30 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clovis, CA; Fresno, CA; Madera, CA; Oakhurst, CA
O20100930028454 CA DME Supplier - Physician - OphthalmologyDME Supplier - Physician - OptometristDME Supplier - Optician 7911993902 Practice locations: Fresno, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Foggmaxwell Lanier E8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1912960253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 E HERNDON AVE",
            "address_2": "401",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203326",
            "telephone_number": "559-449-5010",
            "fax_number": "559-449-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937264301",
            "telephone_number": "559-226-3971",
            "fax_number": "559-241-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOGG REMINGTON EYECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-08",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "PENDLEY",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "559-449-5011",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE DMERC",
            "identifier": "1304310003",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0078920",
            "state": "CA"
        }
    ],
    "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 Apr 5, 2022; 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.