NPIMap

Organization Active NPI

Central California Bariatric Surgery a Medical Corporation

  • Surgery Physician
  • Modesto, CA
National Provider Identifier
1124141163
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A354240 Issued in CA
Legal business name
CENTRAL CALIFORNIA BARIATRIC SURGERY A MEDICAL CORPORATION
Practice address
1001 Sylvan Ave Ste a
Modesto, CA 95350-1699
Phone
(209) 422-6120
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Authorized official

Name
Dr. Patrick James Coates, M.D.NPI 1063479301
Title
Surgeon
Phone
(209) 525-3885

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X A354240 CA Primary

Addresses

Primary practice location

1001 Sylvan Ave Ste a
Modesto, CA 95350-1699

Mailing address

1001 Sylvan Ave Ste a
Modesto, CA 95350-1699
Phone (209) 248-7168

Other practice location 1

1552 Coffee Rd
Suite 200
Modesto, CA 95355-3122
Phone (209) 248-7168

Other practice location 2

644 E Harding Way Ste B
Stockton, CA 95204-6103
Phone (209) 248-7168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051121000631 CA Part B Supplier - Clinic/Group Practice 0547289423 Receives reassigned benefits from 16 practitioners
Practice locations: Modesto, CA; Stockton, CA

National Provider Directory

National Provider Directory

Locations

1001 Sylvan Ave
Modesto, CA 95350

1401 Spanos Ct
Ste 224
Modesto, CA 95355
Phone (209) 525-3885

644 E Harding Way
Stockton, CA 95204

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1124141163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SYLVAN AVE STE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501699",
            "telephone_number": "209-248-7168",
            "fax_number": "209-846-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SYLVAN AVE STE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501699",
            "telephone_number": "209-422-6120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1552 Coffee Rd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953553122",
            "country_code": "US",
            "telephone_number": "209-248-7168",
            "fax_number": "209-846-9641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "644 E Harding Way Ste B",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952046103",
            "country_code": "US",
            "telephone_number": "209-248-7168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL CALIFORNIA BARIATRIC SURGERY A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "COATES",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "209-525-3885",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A354240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.