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

Q: 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.

Q: What is Vira Fomenko's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Vira Fomenko was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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: October 18, 2026.

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

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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

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Secondary Practice Location 1

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

Medicare enrollment records show Vira Fomenko reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Asian Americans For Community Involvement Of Santa Clara County, Inc

Same address

Community/Behavioral Health

2400 MOORPARK AVE, SUITE 300
San Jose, CA 95128

Reassigned Medicare billing, California enrollment
63 clinicians in this Medicare group

NPI 1326052291 (408) 975-2730

Permanente Medical Group Inc

3.6 mi

Internal Medicine

710 LAWRENCE EXPRESSWAY
Santa Clara, CA 95051

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1073606299 (408) 851-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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