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DR. LIDA AVETISYAN MD
NPI 1487334553
Internal Medicine in Fresno, CA

Active since July 24, 2023PECOS Enrolled
1221 E SPRUCE AVE, FRESNO, CA 93720(559) 450-5777(559) 450-5687 Get Directions Write a Review

NPPES record last updated: July 6, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 6, 2026, Jul 24, 2023 (2 updates tracked since 2023).

About Dr. Lida Avetisyan Md NPPES

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

DR. LIDA AVETISYAN MD (NPI 1487334553) is an individual internal medicine provider in Fresno, California, licensed in California (A209872) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Bronx, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1487334553
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. LIDA AVETISYANCredential: MD
Location Address1221 E SPRUCE AVEFresno, CA 93720-3374
Mailing Address1111 E Spruce Ave Ste 431Fresno, CA 93720-3330 · (559) 450-7449 · Fax (559) 450-7472
Phone(559) 450-5777
Fax(559) 450-5687
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJuly 24, 2023
Last NPPES UpdateJuly 6, 20262 updates tracked since enumeration
NPPES CertifiedJuly 6, 2026
✔ NPI 1487334553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A209872
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1221 E SPRUCE AVE, Fresno, CA 93720
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Secondary Practice Location 1

Location 1234 E 149th StBronx, NY 10451-5504 · Phone (718) 579-5000

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Lida Avetisyan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8527527092
PECOS Enrollment IDI20260825003209
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 Reassignment

Medicare enrollment records show Lida Avetisyan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Saint Agnes Medical Foundation
0.4 mi
Internal Medicine
1303 E HERNDON AVE, SUITE 850
Fresno, CA 93720
  • Reassigned Medicare billing, California enrollment
  • 296 clinicians in this Medicare group
NPI 1558819482 (559) 450-5611

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 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
$133.94 typical visit price
range $58.87 – $176.60
Typical copayment $33.48 (range $14.71 – $44.15)
Most-billed visit code 99204
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
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.

MARKOS H ZEMEDE MD
Internal Medicine
1221 E SPRUCE AVE
FRESNO, CA 93720
Fresno County (559) 450-5777
MARLA ANN PETRIELLO DO
Physical Medicine & Rehabilitation
1221 E SPRUCE AVE
FRESNO, CA 93720
Fresno County (872) 231-3162
DWAYNE R DEPRY DO INC
Psychiatry & Neurology (Psychiatry)
1221 E SPRUCE AVE
FRESNO, CA 93720
Fresno County (559) 261-2799
DR. TRAVIS JUSTIN CHEN MD
Family Medicine
1221 E SPRUCE AVE
FRESNO, CA 93720
Fresno County (559) 450-5777
MAI N PHAM MD
Internal Medicine
1221 E SPRUCE AVE
FRESNO, CA 93720
Fresno County (559) 450-5777
JASPREET KAUR DO
Family Medicine
1221 E SPRUCE AVE
FRESNO, CA 93720
Fresno County (559) 450-5777
JULIE M MITCHELL MD
Internal Medicine
1221 E SPRUCE AVE
FRESNO, CA 93720
Fresno County (559) 450-5777
LQMG MEDICAL GROUP INC.
Internal Medicine
1221 E SPRUCE AVE
FRESNO, CA 93720
Fresno County (559) 450-5777

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 Lida Avetisyan's NPI number?

The NPI number for Lida Avetisyan is 1487334553. It was assigned to this individual provider in the NPPES registry on July 24, 2023.

Where is Lida Avetisyan located?

Lida Avetisyan practices at 1221 E Spruce Ave, Fresno, CA 93720. The listed phone number is (559) 450-5777.

What is Lida Avetisyan's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Lida Avetisyan enrolled in Medicare?

Yes. Lida Avetisyan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lida Avetisyan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lida Avetisyan reassigns Medicare benefits to Saint Agnes Medical Foundation (Fresno, CA). The 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 Lida Avetisyan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Lida Avetisyan was last updated on July 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.