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VIRA FOMENKO MD
NPI 1023512456
Family Medicine in San Jose, CA

Active since March 20, 2018PECOS EnrolledAccepts Medicare Assignment
2400 MOORPARK AVE STE 300, SAN JOSE, CA 95128(408) 975-2730(408) 975-2764 Get Directions Write a Review

NPPES record last updated: November 21, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 21, 2025, Dec 20, 2021, Mar 20, 2018 (3 updates tracked since 2018).

About Vira Fomenko Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VIRA FOMENKO MD (NPI 1023512456) is an individual family medicine provider in San Jose, California, licensed in California (A164062) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS, maintains a secondary practice location in San Jose, and is a graduate of Un Of California, Irvine, College Of Medicine (2018).

NPPES Registry Identity

NPI1023512456
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameVIRA FOMENKOCredential: MD
Location Address2400 MOORPARK AVE STE 300San Jose, CA 95128-2680
Mailing Address2400 Moorpark Ave Ste 300San Jose, CA 95128-2680 · (408) 975-2730 · Fax (408) 975-2764
Phone(408) 975-2730
Fax(408) 975-2764
Sole ProprietorNo
Medical School CMSUn Of California, Irvine, College Of MedicineGraduated 2018
Enumeration DateMarch 20, 2018
Last NPPES UpdateNovember 21, 20253 updates tracked since enumeration
NPPES CertifiedNovember 21, 2025
✔ NPI 1023512456 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A164062
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2400 MOORPARK AVE STE 300, San Jose, CA 95128
Open in Google Maps ↗

Secondary Practice Location 1

Location 1250 Hospital PkwySan Jose, CA 95119-1103 · Phone (408) 972-3000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Vira Fomenko Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1254749773
PECOS Enrollment IDI20210920002661
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95128 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$121.77 typical visit price
range $23.96 – $169.60
Typical copayment $30.44 (range $5.99 – $42.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEE Y LEE
Marriage & Family Therapist
2400 MOORPARK AVE STE 300
SAN JOSE, CA 95128
Santa Clara County (408) 975-2730
FREEDMAN OUK
Community Health Worker
2400 MOORPARK AVE STE 300
SAN JOSE, CA 95128
Santa Clara County (408) 275-2730
CHRISTINA NGUYEN
Marriage & Family Therapist
2400 MOORPARK AVE STE 300
SAN JOSE, CA 95128
Santa Clara County (408) 975-2730
AIDOLE JINELYE ARTEAGA
Community Health Worker
2400 MOORPARK AVE STE 300
SAN JOSE, CA 95128
Santa Clara County (408) 975-2730
BRICE GOODEN RN
Registered Nurse
2400 MOORPARK AVE STE 300
SAN JOSE, CA 95128
Santa Clara County (408) 975-2730
DR. MY LINH THI VO
Psychologist
2400 MOORPARK AVE STE 300
SAN JOSE, CA 95128
Santa Clara County (408) 975-2730
RUOXI CHI
Marriage & Family Therapist
2400 MOORPARK AVE STE 300
SAN JOSE, CA 95128
Santa Clara County (408) 975-2730
JACQUELINE HARPER PSYD
Psychologist
2400 MOORPARK AVE STE 300
SAN JOSE, CA 95128
Santa Clara County (408) 975-2730

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vira Fomenko's NPI number?

The NPI number for Vira Fomenko is 1023512456. It was assigned to this individual provider in the NPPES registry on March 20, 2018.

Where is Vira Fomenko located?

Vira Fomenko practices at 2400 Moorpark Ave Ste 300, San Jose, CA 95128. The listed phone number is (408) 975-2730.

What is Vira Fomenko's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Vira Fomenko enrolled in Medicare?

Yes. Vira Fomenko is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Vira Fomenko was last updated on November 21, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.