Organization Active NPI

Fogg Remington Eyecare, Inc.

  • Ophthalmology Physician
  • Madera, CA
National Provider Identifier
1992768238
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
2401 W Cleveland Ave
Madera, CA 93637-3608
Phone
(559) 661-7545
Fax
(559) 661-7314
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

2401 W Cleveland Ave
Madera, CA 93637-3608

Mailing address

1360 E Herndon Ave Ste 401
Fresno, CA 93720-3326
Phone (559) 661-7545

Other identifiers 2

IdentifierTypeStateIssuer
1304310001OtherCACIGNA MEDICARE DMERC
GR0078923MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

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

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

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": "1992768238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 E HERNDON AVE STE 401",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203326",
            "telephone_number": "559-661-7545",
            "fax_number": "559-661-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W CLEVELAND AVE",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936373608",
            "telephone_number": "559-661-7545",
            "fax_number": "559-661-7314"
        }
    ],
    "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": "1304310001",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0078923",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, 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.