Individual provider Active NPI

Sy Sophamixay-Essegian, D.O.

  • Family Medicine Physician
  • Kingsburg, CA
National Provider Identifier
1992936157
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A10120 Issued in CA
Practice address
121 Sierra St
Kingsburg, CA 93631-1732
Phone
(559) 326-5320
NPI assigned
Aug 5, 2009
Last updated
Jun 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A10120 CA Primary

Addresses

Primary practice location

121 Sierra St
Kingsburg, CA 93631-1732

Mailing address

4969 E Floradora Ave
Fresno, CA 93727-1924
Phone (559) 892-8795

Other practice location 1

2141 High St
Selma, CA 93662-3065
Phone (559) 891-2611

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
I20091106000227 CA Practitioner - Family Practice 9234277542 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A10120CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reedley Community Hospital CurrentSince Mar 1, 2024 Accepting new patients
Valley Health Team, Inc CurrentSince May 18, 2022 Accepting new patients
Valley Health Team, Inc. Current Accepting new patients
Valley Health Team, Inc. Family Medicine Current Accepting new patients
Reedley Community Hospital CurrentSince Mar 1, 2024 Accepting new patients
Valley Health Team Inc. CurrentSince May 18, 2022 Accepting new patients
Hanford Community Hospital Past Accepting new patients
Central Valley General Hospital Past Accepting new patients

Locations

250 W El Monte Way
Dinuba, CA 93618
Phone (559) 595-9890

121 W Sierra St
Kingsburg, CA 93631
Phone (559) 326-5320

1250 Smith St
Kingsburg, CA 93631
Phone (559) 326-5320

372 W Cypress Ave
Reedley, CA 93654
Phone (559) 391-3110

811 E 11th St
Reedley, CA 93654
Phone (559) 391-3120

21890 W Colorado Ave
San Joaquin, CA 93660
Phone (559) 693-2462

2141 High St
Selma, CA 93662
Phone (559) 856-6110

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1992936157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4969 E FLORADORA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937271924",
            "telephone_number": "559-892-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 SIERRA ST",
            "city": "KINGSBURG",
            "state": "CA",
            "postal_code": "936311732",
            "telephone_number": "559-326-5320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2141 High St",
            "address_purpose": "LOCATION",
            "city": "Selma",
            "state": "CA",
            "postal_code": "936623065",
            "country_code": "US",
            "telephone_number": "559-891-2611",
            "fax_number": "559-891-2616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOPHAMIXAY-ESSEGIAN",
        "first_name": "SY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-05",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A10120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsburg, CA

Sources for this page

Verify at the official NPI Registry.