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DR. RICHARD KENNETH ELIA M.D.
NPI 1841499381
Family Medicine in Fresno, CA

Active since July 14, 2007PECOS EnrolledCLIA 05D2089369 · Waiver
11.86/100
CMS Quality Rating
5375 N PALM AVE, FRESNO, CA 93704(559) 435-3542(559) 431-2457 Get Directions Write a Review

NPPES record last updated: October 25, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Richard Kenneth Elia M.d. NPPES

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

DR. RICHARD KENNETH ELIA M.D. (NPI 1841499381) is an individual family medicine provider in Fresno, California, licensed in California (A100727) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through December 28, 2026, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1841499381
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. RICHARD KENNETH ELIACredential: M.D.
Location Address5375 N PALM AVEFresno, CA 93704-2206
Mailing Address5375 North PalmFresno, CA 93704-2206 · (559) 435-3542 · Fax (559) 431-2457
Phone(559) 435-3542
Fax(559) 431-2457
Sole ProprietorYes
Medical School CMSOtherGraduated 2003
Enumeration DateJuly 14, 2007
Last NPPES UpdateOctober 25, 2011
✔ NPI 1841499381 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A100727
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
5375 N PALM AVE, Fresno, CA 93704
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Other Identifiers 1

Medicare PINA100727CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Richard Kenneth Elia M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9335238450
PECOS Enrollment IDI20071127000695
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.

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 05D2089369

Richard K Elia MD · Fresno, CA
Active · expires Dec 28, 2026
CLIA Number05D2089369
Laboratory TypePhysician Office
Certificate Effective DateDecember 29, 2024
Certificate Expiration DateDecember 28, 2026
Laboratory DirectorRichard K. Elia
Laboratory Phone(559) 435-3542
Laboratory LocationRichard K Elia MD5375 N Palm Ave, Fresno, CA 93704
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
546 services181 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
340 services160 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
45 services45 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
45 services45 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
34 services23 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
18 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93704 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
$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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

11.86/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0
Cost39.56

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
93%7,141 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
51%198 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers26 claims61 services$4.52 avg. paid by Medicare
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620
DME-Drugs Administered Through DME · category DG006N
1 supplier13 claims1,170 services$0.10 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Richard Elia's NPI number?

The NPI number for Richard Elia is 1841499381. It was assigned to this individual provider in the NPPES registry on July 14, 2007.

Where is Richard Elia located?

Richard Elia practices at 5375 N Palm Ave, Fresno, CA 93704. The listed phone number is (559) 435-3542.

What is Richard Elia's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Richard Elia enrolled in Medicare?

Yes. Richard Elia is registered in the Medicare PECOS enrollment system.

Does Richard Elia hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2089369) is associated with this NPI, valid through December 28, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Richard Elia was last updated on October 25, 2011. 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.