Individual provider Active NPI

Gus Jr Solis, PA-C

  • Physician Assistant
  • Modesto, CA
National Provider Identifier
1104780063
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
67720 Issued in CA
Practice address
1441 Florida Ave
Modesto, CA 95350-4418
Phone
(626) 484-5448
NPI assigned
Dec 15, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 67720 CA Primary

Addresses

Primary practice location

1441 Florida Ave
Modesto, CA 95350-4418

Mailing address

1441 Florida Ave
Hospitalist Suite
Modesto, CA 95350-4404
Phone (626) 484-5448

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
I20260427001561 CA Practitioner - Physician Assistant 2961979083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1700 McHenry Ave
Suite 65B
Modesto, CA 95350-4331

220 Standiford Ave
Suite F
Modesto, CA 95350-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
67720CAMDPharmacist

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1765756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1104780063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "address_2": "HOSPITALIST SUITE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504404",
            "telephone_number": "626-484-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504418",
            "telephone_number": "626-484-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLIS",
        "first_name": "GUS",
        "middle_name": "JR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-15",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "67720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.