GETTYSBURG MEDICAL CLINIC INC
NPI 1174989594
Clinic/Center - Primary Care in Atwater, CA
About Gettysburg Medical Clinic Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GETTYSBURG MEDICAL CLINIC INC (NPI 1174989594) is a healthcare organization registered as a primary care in Atwater, California and active in the NPI registry since January 2016. The organization lists Johnny Yee Fong, Medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
Gettysburg Medical Clinic Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 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
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Gettysburg Medical Clinic Inc, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Gettysburg Medical Clinic Inc's NPI number?
The NPI number for Gettysburg Medical Clinic Inc is 1174989594. It was assigned to this organization in the NPPES registry on January 14, 2016.
Where is Gettysburg Medical Clinic Inc located?
Gettysburg Medical Clinic Inc is located at 1834 Bellevue Rd, Atwater, CA 95301. The listed phone number is (209) 285-9688.
What is Gettysburg Medical Clinic Inc's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Gettysburg Medical Clinic Inc enrolled in Medicare?
Yes. Gettysburg Medical Clinic Inc is registered in the Medicare PECOS enrollment system.
When is Gettysburg Medical Clinic Inc'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 March 31, 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 Gettysburg Medical Clinic Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Gettysburg Medical Clinic Inc, in Allergy/Immunology, Internal Medicine and Nurse Practitioner. 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.
When was this NPI record last updated?
The NPPES record for Gettysburg Medical Clinic Inc was last updated on January 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Gettysburg Medical Clinic Inc · NPI 1174989594
Primary Care organization in Atwater, California. Organization record, active in the CMS NPPES registry since January 14, 2016.
## Identity
- **NPI:** 1174989594 (Entity type: Organization)
- **Enumerated:** January 14, 2016
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Johnny Fong, MEDICAL DIRECTOR
## Practice location
- **Address:** 1834 BELLEVUE RD, Atwater, CA 95301-2670
- **Phone:** (209) 285-9688 · **Fax:** (209) 725-2072
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 4 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Allergy/Immunology (1), Internal Medicine (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 14, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1174989594) · Data from the CMS NPPES public registry.