Unknown Individual – Family Medicine Physician, NPI 1528068442
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
21,508 INTERNAL MEDICINE in CA
Loading map...
Provider Addresses for Unknown Individual
110, North Valeria Street, Fresno, Fresno County, California, 93701, United States
SUITE 501
FRESNO, CA 93701
Phone: (559) 442-8737
Fax: (559) 442-3587
Type: Mailing
6061 N 1ST ST STE 102
FRESNO, CA 937105470
Phone: (559) 442-8737
Fax: (559) 442-3587
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $828.
Total Amount is formed as General ($828) + Research ($0) + Ownership ($0) = $828.
Last reported payment date: 2024-08-07 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($487).
Total Amount
$828
General + Research + Ownership
Payments
9
Total payment records
General Amount
$828
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $487 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $316 |
| PFIZER INC. | $25 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100927000850 | I | Internal Medicine | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 478 | 202 | $0 |
| J0694 | Injection, cefoxitin sodium, 1 gm | 128 | 30 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 62 | 49 | $0 |
| 90756 | Influenza vaccine, quadrivalent derived from cell cultures | 58 | 57 | $0 |
| G0008 | Administration of influenza virus vaccine | 58 | 57 | $0 |
Insurance plans in this area (ZIP 93701)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.