KINGS WINERY MEDICAL CLINIC
NPI 1265521488
Exclusive Provider Organization in Fresno, CA

Active since October 12, 2006
4929 E KINGS CANYON RD, FRESNO, CA 93727(559) 255-6476(559) 255-7906 Get Directions Write a Review

NPPES record last updated: April 29, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Kings Winery Medical Clinic NPPES

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

KINGS WINERY MEDICAL CLINIC (NPI 1265521488) is a healthcare organization registered as an exclusive provider organization in Fresno, California and active in the NPI registry since October 2006. The organization lists Bla Mouanoutoua, Ceo, as its authorized official.

NPPES Registry Identity

NPI1265521488
Entity TypeOrganization
Primary Taxonomy302F00000X
Legal Business NameGREATER FRESNO HEALTH ORGANIZATION, INC.
Location Address4929 E KINGS CANYON RDFresno, CA 93727-3812
Mailing Address4929 E Kings Canyon RdFresno, CA 93727-3812 · (559) 255-6476 · Fax (559) 255-7906
Fax(559) 255-7906
Organization SubpartNo
Authorized OfficialBla MouanoutouaCeo · (559) 255-6476
Enumeration DateOctober 12, 2006
Last NPPES UpdateApril 29, 2024
NPPES CertifiedApril 29, 2024
✔ NPI 1265521488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyExclusive Provider OrganizationManaged Care Organizations
Taxonomy Code302F00000X
License✔ Licensed in CA · 04000036
Definition
(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.
4929 E KINGS CANYON RD, Fresno, CA 93727

Other Names 1

Doing Business AsKings Winery Medical Clinic

Other Identifiers 1

MedicaidFHC70517FCA

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kings Winery Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

16

Medicare enrollment records show 16 clinicians reassign Medicare billing to Kings Winery Medical Clinic, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 15 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 5

Nurse Practitioner12
Internal Medicine1
Pediatric Medicine1
Podiatry1
Psychiatry1

Clinicians, nearest first (16)

Nurse Practitioner
NPI 1588440846
4929 E KINGS CANYON RD
Fresno, CA 93727
(559) 255-6477
✔ PECOSSame address
Nurse Practitioner
NPI 1780439836
4929 E KINGS CANYON RD
Fresno, CA 93727
(559) 255-6476
✔ PECOSSame address
Nurse Practitioner
NPI 1649438425
4929 E KINGS CANYON RD
Fresno, CA 93727
(559) 255-6476
✔ PECOSSame address
Psychiatry
NPI 1215018783
4929 E KINGS CANYON RD
Fresno, CA 93727
(559) 255-6476
✔ PECOS0.1 mi
Nurse Practitioner
NPI 1689264418
2042 KERN ST
Fresno, CA 93721
(559) 400-6420
✔ PECOS3.2 mi
Internal Medicine
NPI 1801882360
807 N VAN NESS AVE
Fresno, CA 93728
(559) 499-1233
✔ PECOS4.0 mi
Nurse Practitioner
NPI 1083293641
3790 N 1ST ST
Fresno, CA 93726
(559) 890-6111
✔ PECOS4.2 mi
Pediatric Medicine
NPI 1053401927
3790 N 1ST ST
Fresno, CA 93726
(559) 340-3400
✔ PECOS4.2 mi
Nurse Practitioner
NPI 1932897444
4770 N CEDAR AVE
Fresno, CA 93726
(559) 860-4900
✔ PECOS4.9 mi
Nurse Practitioner
NPI 1053123216
4770 N CEDAR AVE
Fresno, CA 93726
(559) 860-4900
✔ PECOS4.9 mi
Nurse Practitioner
NPI 1558195073
1570 E HERNDON AVE
Fresno, CA 93720
(559) 603-7240
✔ PECOS✔ Accepts Medicare7.2 mi
Nurse Practitioner
NPI 1952866568
4011 N MARKS AVE
Fresno, CA 93722
(559) 860-4925
✔ PECOS7.5 mi
Nurse Practitioner
NPI 1649928219
4011 N MARKS AVE
Fresno, CA 93722
(559) 860-4925
✔ PECOS✔ Accepts Medicare7.5 mi
Nurse Practitioner
NPI 1760019806
4011 N MARKS AVE
Fresno, CA 93722
(559) 860-4925
✔ PECOS7.5 mi
Nurse Practitioner
NPI 1245784883
4011 N MARKS AVE
Fresno, CA 93722
(559) 860-4925
✔ PECOS7.5 mi
Podiatry
NPI 1669041976
5220 PACIFIC CONCOURSE DR
Los Angeles, CA 90045
(800) 373-5400
✔ PECOS208 mi

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 Greater Fresno Health Organization, Inc.'s NPI number?

The NPI number for Greater Fresno Health Organization, Inc. is 1265521488. It was assigned to this organization in the NPPES registry on October 12, 2006. The provider is doing business as Kings Winery Medical Clinic.

Where is Greater Fresno Health Organization, Inc. located?

Greater Fresno Health Organization, Inc. is located at 4929 E Kings Canyon Rd, Fresno, CA 93727. The listed phone number is (559) 255-6476.

What is Greater Fresno Health Organization, Inc.'s specialty?

The primary specialty registered for this NPI is Exclusive Provider Organization with taxonomy code 302F00000X.

Is Greater Fresno Health Organization, Inc. enrolled in Medicare?

Yes. Greater Fresno Health Organization, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Greater Fresno Health Organization, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 16 clinicians in 5 Medicare specialties reassign their Medicare billing to Greater Fresno Health Organization, Inc.. 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. The largest specialties are Nurse Practitioner (12), Internal Medicine (1) and Pediatric Medicine (1). Of these, 3 practice at this address and 15 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Greater Fresno Health Organization, Inc. was last updated on April 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.