CCARE – Hematology & Oncology Physician, NPI 1083661607
Hematology & Oncology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CCARE
PO BOX 25100
FRESNO, CA 937295100
Phone: (559) 326-1222
Fax: (559) 326-1230
Type: Mailing
838 Nordahl Rd Ste 300
San Marcos, CA 920693599
Phone: (760) 747-8935
Type: Location
1125 E Spuce Ave.
Suit 103
Fresno, CA 937203387
Phone: (559) 878-4510
Type: Location
959 Lane Ave Ste 100
Chula Vista, CA 919144519
Phone: (619) 329-5571
Type: Location
28078 Baxter Rd Ste 140
Murrieta, CA 925631403
Phone: (760) 733-9191
Type: Location
4500 Brockton Ave Ste 319
Riverside, CA 925014027
Phone: (951) 319-7326
Type: Location
326 Santa Fe Dr Ste 105
Encinitas, CA 920245157
Phone: (760) 452-3340
Type: Location
9850 Genesee Ave Ste 560
LA Jolla, CA 920371229
Phone: (858) 552-1410
Type: Location
16918 Dove Canyon Rd Ste 103
San Diego, CA 921273455
Phone: (858) 649-5100
Type: Location
North Millbrook Avenue, Fresno, Fresno County, California, 93726, United States
FRESNO, CA 93720
Phone: (559) 326-1222
Fax: (559) 326-1230
Type: Location
104 WOODMONT BLVD STE 500
NASHVILLE, TN 372052245
Phone: (615) 252-7212
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-01-08
PECOS data refreshed: 2026-05-27
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 |
|---|---|---|---|---|
| O20040108001068 | O | Clinic/Group Practice | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 93729)
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Reviews
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