Individual provider Active NPI

Tracy Iris Gastelum, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1033921903
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95033701 Issued in CA
Practice address
1700 Coffee Rd
Modesto, CA 95355-2803
Phone
(209) 526-4500
NPI assigned
Jan 27, 2025
Last updated
Aug 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95033701 CA Primary

Addresses

Primary practice location

1700 Coffee Rd
Modesto, CA 95355-2803

Mailing address

PO Box 255228
Sacramento, CA 95865-5228
Phone (800) 470-0071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250612001260 CA Practitioner - Nurse Practitioner 6103336656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

1700 Coffee Rd
Modesto, CA 95355-2803
Phone (209) 526-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Current Accepting new patients
Cep America - California CurrentSince May 15, 2025 Accepting new patients
Cep America-California CurrentSince May 15, 2025 Accepting new patients

Locations

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1700 Coffee Rd
Modesto, CA 95355
Phone (209) 526-4500

Interoperability endpoints

  • Direct secure messaging: tgastelum743298@hisp.ehr.sutterhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1033921903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228",
            "telephone_number": "800-470-0071",
            "fax_number": "916-854-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552803",
            "telephone_number": "209-526-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASTELUM",
        "first_name": "TRACY",
        "middle_name": "IRIS",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-27",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95033701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.