Larry Jess Destjeor (NPI# 1417953472, PAC ID# 6507823051) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1417953472 |
| PAC ID by PECOS | 6507823051 |
| Professional Enrollment ID | I20041216000917 |
| Full Name | Larry Jess Destjeor |
| Organization Legal Name | WISHON RADIOLOGICAL MEDICAL GROUP INC |
| Address |
1303 E Herndon Ave Fresno CA 93720-3309 |
| Phone Number | 5594503000 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF UTAH SCHOOL OF MEDICINE |
| Graduation Year | 1972 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 8022065036 |
| Number of Group Practice Members | 36 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050093 | SAINT AGNES MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1303 E Herndon Ave, Fresno, CA 93720-3309 | 5594503000 | WISHON RADIOLOGICAL MEDICAL GROUP INC |
| 7202 N Millbrook Ave, Suite 206, Fresno, CA 93720-3341 | 5594502662 | WISHON RADIOLOGICAL MEDICAL GROUP INC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_436_overall | Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques | 61% | |
| MIPS_EC_436_overall | Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques | 61% | |
| MIPS_EC_436_overall | Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques | 61% |
| Organization Legal Name | WISHON RADIOLOGICAL MEDICAL GROUP INC |
| Physicians | 24 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Roberta K Yang | Diagnostic Radiology | Wishon Radiological Medical Group Inc | 5765 N Fresno St, Suite 105, Fresno, CA 93710-6092 |
| Brandon W. Chan | Diagnostic Radiology | Wishon Radiological Medical Group Inc | 126 Marlboro Dr, Mc Murray, PA 15317-3651 |
| Lin Hsu Bailey | Diagnostic Radiology | Wishon Radiological Medical Group Inc | 9300 Valley Childrens Pl, Madera, CA 93636-8761 |
| Terril A Efird | Diagnostic Radiology | Wishon Radiological Medical Group Inc | 9300 Valley Childrens Pl, Madera, CA 93636-8761 |
| Benjamin Pruett | Interventional Radiology | Wishon Radiological Medical Group Inc | 1303 E Herndon Ave, Fresno, CA 93720-3309 |
| Robert Raines-hepple | Diagnostic Radiology | Wishon Radiological Medical Group Inc | 9300 Valley Childrens Pl, Madera, CA 93636-8761 |
| Trevor Davis | Interventional Radiology | Wishon Radiological Medical Group Inc | 9300 Valley Childrens Pl, Madera, CA 93636-8761 |
| Tyler George Gasser | Diagnostic Radiology | Wishon Radiological Medical Group Inc | 9300 Valley Childrens Pl, Madera, CA 93636-8761 |
| Sampath Kumar Alapati | Diagnostic Radiology | Wishon Radiological Medical Group Inc | 9300 Valley Childrens Pl, Madera, CA 93636-8761 |
| Michael R Myracle | Diagnostic Radiology | Wishon Radiological Medical Group Inc | 9300 Valley Childrens Pl, Madera, CA 93636-8761 |
| Street Address |
1303 E HERNDON AVE |
| City | FRESNO |
| State | CA |
| Zip | 93720-3309 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michelle Denise Septer | Nurse Practitioner | Cep America - California | 1303 E Herndon Ave, Fresno, CA 93720-3309 |
| Chinnapa R Nareddy | Hospitalist | Saint Agnes Medical Center | 1303 E Herndon Ave, Fresno, CA 93720-3309 |
| James Simmons | Hospitalist | Galen Inpatient Physicians Inc | 1303 E Herndon Ave, Fresno, CA 93720-3309 |
| Geralyn Alyssa Roberson | Nurse Practitioner | Cep America - California | 1303 E Herndon Ave, Fresno, CA 93720-3309 |
| Joshua Lin | Hospitalist | Vituity Hospitalists PC | 1303 E Herndon Ave, Fresno, CA 93720-3309 |
| Jonathan Caldwell | Emergency Medicine | Saint Agnes Medical Center | 1303 E Herndon Ave, Fresno, CA 93720-3309 |
| Benjamin Pruett | Interventional Radiology | Wishon Radiological Medical Group Inc | 1303 E Herndon Ave, Fresno, CA 93720-3309 |
| Venkataramana K Reddy | Hospitalist | Galen Inpatient Physicians Inc | 1303 E Herndon Ave, Fresno, CA 93720-3309 |
| John P Phillips | Emergency Medicine | Saint Agnes Medical Center | 1303 E Herndon Ave, Fresno, CA 93720-3309 |
| Camie J Sorensen | Emergency Medicine | Saint Agnes Medical Center | 1303 E Herndon Ave, Fresno, CA 93720-3309 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Terry A Gillian | Plastic and Reconstructive Surgery | 1193 E Herndon, Suite 106, Fresno, CA 93720 | |
| Hongshik Han | Plastic and Reconstructive Surgery | 7005 N Maple, Suite 107, Fresno, CA 93720 | |
| Mari Jo Hanson | Physician Assistant | Urology Associates of Central California Med Grp, Inc | 7014 N Whitney, Fresno, CA 93720-0153 |
| Berhane Mebratu | Nurse Practitioner | Urology Associates of Central California Medical Group Inc | 7014 N Whitney Ave, Fresno, CA 93720-0155 |
| Yuk-yuen M Leung | Urology | Urology Associates of Central California Medical Group Inc | 7014 N Whitney Ave, Fresno, CA 93720-0155 |
| Steven M Kurtzman | Radiation Oncology | Western Radiation Oncology Inc | 7014 N Whitney Ave, Fresno, CA 93720-0155 |
| Peter J Garcia | Nurse Practitioner | Urology Associates of Central California Medical Group Inc | 7014 N Whitney Ave, Fresno, CA 93720-0155 |
| Kuldip J Behniwal | Urology | Urology Associates of Central California Medical Group Inc | 7014 N Whitney Ave, Fresno, CA 93720-0155 |
| John C Julian | Urology | Urology Associates of Central California Medical Group Inc | 7014 N Whitney Ave, Fresno, CA 93720-0155 |
| William M Schiff | Urology | Urology Associates of Central California Medical Group Inc | 7014 N Whitney Ave, Fresno, CA 93720-0155 |
| Find all physicians in zip 93720 | |||
| City | FRESNO |
| Zip Code | 93720 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | FRESNO + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Larry Jess Destjeor.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.