MRS. KIMBERLY LAVERNE OBIDIEGWU PA
NPI 1083228738
Physician Assistant in Fresno, CA

Active since September 01, 2020PECOS Enrolled
1207 E HERNDON AVE, FRESNO, CA 93720(559) 432-4303 Get Directions Write a Review

NPPES record last updated: September 1, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mrs. Kimberly Laverne Obidiegwu Pa NPPES

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

MRS. KIMBERLY LAVERNE OBIDIEGWU PA (NPI 1083228738) is an individual physician assistant in Fresno, California, licensed in California (PENDING) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083228738
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. KIMBERLY LAVERNE OBIDIEGWUCredential: PA
Location Address1207 E HERNDON AVEFresno, CA 93720-3235
Mailing Address40370 Road 222Bass Lake, CA 93604-9702 · (559) 779-7438
Sole ProprietorYes
Enumeration DateSeptember 1, 2020
NPPES CertifiedSeptember 1, 2020
NPI 1083228738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in CA · PENDING
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1207 E HERNDON AVE, Fresno, CA 93720

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Mrs. Kimberly Laverne Obidiegwu Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 93720 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
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
Most-billed visit code 99213
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 19

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

Nurse Practitioner (Family)
1207 E HERNDON AVE
FRESNO, CA 93720
Nurse Practitioner (Family)
1207 E HERNDON AVE
FRESNO, CA 93720
Internal Medicine (Interventional Cardiology)
1207 E HERNDON AVE
FRESNO, CA 93720
Internal Medicine (Clinical Cardiac Electrophysiology)
1207 E HERNDON AVE
FRESNO, CA 93720
Internal Medicine (Cardiovascular Disease)
1207 E HERNDON AVE
FRESNO, CA 93720
Internal Medicine (Interventional Cardiology)
1207 E HERNDON AVE
FRESNO, CA 93720
Internal Medicine (Cardiovascular Disease)
1207 E HERNDON AVE
FRESNO, CA 93720
Internal Medicine (Interventional Cardiology)
1207 E HERNDON AVE
FRESNO, CA 93720

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 Kimberly Obidiegwu's NPI number?

The NPI number for Kimberly Obidiegwu is 1083228738. It was assigned to this individual provider in the NPPES registry on September 1, 2020.

Where is Kimberly Obidiegwu located?

Kimberly Obidiegwu practices at 1207 E Herndon Ave, Fresno, CA 93720. The listed phone number is (559) 432-4303.

What is Kimberly Obidiegwu's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kimberly Obidiegwu enrolled in Medicare?

Yes. Kimberly Obidiegwu is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kimberly Obidiegwu was last updated on September 1, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.