FONTANA CLINICA MEDICA FAMILIAR
NPI 1174621585
Family Medicine in Fontana, CA
About Fontana Clinica Medica Familiar NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FONTANA CLINICA MEDICA FAMILIAR (NPI 1174621585) is a healthcare organization registered as a family medicine in Fontana, California and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through June 13, 2028 and lists Octavio Ruiz-villalpando, Medical Director/ Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fontana Clinica Medica Familiar is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Fontana Clinica Medica Familiar, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 05D0981384
Fontana Clinica Medica Familiar · Fontana, CAFrequently 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 Fontana Physicians Associates A Medical Corporation's NPI number?
The NPI number for Fontana Physicians Associates A Medical Corporation is 1174621585. It was assigned to this organization in the NPPES registry on September 20, 2006. The provider is doing business as Fontana Clinica Medica Familiar.
Where is Fontana Physicians Associates A Medical Corporation located?
Fontana Physicians Associates A Medical Corporation is located at 17695 Arrow Blvd, Fontana, CA 92335. The listed phone number is (909) 854-3790.
What is Fontana Physicians Associates A Medical Corporation's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Fontana Physicians Associates A Medical Corporation enrolled in Medicare?
Yes. Fontana Physicians Associates A Medical Corporation is registered in the Medicare PECOS enrollment system.
When is Fontana Physicians Associates A Medical Corporation's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Fontana Physicians Associates A Medical Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Fontana Physicians Associates A Medical Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Fontana Physicians Associates A Medical Corporation hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D0981384) is associated with this NPI, valid through June 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Fontana Physicians Associates A Medical Corporation was last updated on February 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.
# Fontana Clinica Medica Familiar · NPI 1174621585
Family Medicine organization in Fontana, California. Organization record, active in the CMS NPPES registry since September 20, 2006.
## Identity
- **NPI:** 1174621585 (Entity type: Organization)
- **Enumerated:** September 20, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Fontana Physicians Associates A Medical Corporation
- **Organization subpart:** No
- **Authorized official:** Octavio Ruiz-Villalpando, MEDICAL DIRECTOR/ OWNER
## Practice location
- **Address:** 17695 ARROW BLVD, Fontana, CA 92335-4041
- **Phone:** (909) 854-3790 · **Fax:** (909) 854-3792
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 20, 2012
- **Other identifiers:** Medicare PIN ZZZ14665Z (CA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1174621585) · Data from the CMS NPPES public registry.