Active NPI
Central Valley Specialty Hospital, Inc.
- Meals Provider
- Modesto, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Meals Provider
- Legal business name
- CENTRAL VALLEY SPECIALTY HOSPITAL, INC.
- Practice address
- 730 17TH St
Modesto, CA 95354-1209 - Phone
- (209) 576-2532
- Fax
- (209) 576-2598
- NPI assigned
- Oct 1, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tammy Jean Thompson
- Title
- VP Finance
- Phone
- (209) 248-7851
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Meals Provider | 174200000X | Primary |
Addresses
Primary practice location
730 17TH St
Modesto, CA 95354-1209
Mailing address
1320 Standiford Ave
Suite 4 PMB 214
Modesto, CA 95350-0726
Phone (209) 576-2532
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130212000549 | CA | Part A Provider - Hospital | 8325292717 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Modesto, CA |
Hospital certification: CCN 052055
- Legal name
- CENTRAL VALLEY SPECIALTY HOSPITAL INC
- Doing business as
- CENTRAL VALLEY SPECIALTY HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Long-term
- Participating since
- Aug 28, 2013
- Last certification
- Jun 5, 2025
- Beds
- 96
- Ownership / control type
- Private (for profit)
- Organization structure
- Corporation
- Incorporated
- Sep 11, 2012 in CA
- Enrollment address
- 730 17TH St
Modesto, CA 95354-1209 - Hospital subgroups
- Long-term
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- General Acute Care Hospital
- Modesto, CA
- NPI 1578989703
O20130212000549
Care Compare: Long-term care hospital
Medicare Care Compare- Listed as
- Central Valley Specialty Hospital
- Ownership
- For profit
- Certified
- Aug 28, 2013
- Medicare certification status
- Active
- Beds
- 36
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Gurpreet Singh Randhawa | 5% Or Greater Direct Ownership Interest | Jul 1, 2015 | 100% |
| Corporate Officer | Jul 1, 2015 | 100% | |
| Corporate Director | Jul 1, 2015 | 100% | |
| W-2 Managing Employee | Jul 1, 2015 | 100% | |
| Operational/Managerial Control | Jul 1, 2015 | 100% | |
| Shamsher Bhullar | Corporate Director | Jul 13, 2022 | |
| Tammy Thompson | Corporate Officer | Jul 18, 2016 | |
| Corporate Director | Jul 18, 2016 | ||
| Operational/Managerial Control | Jul 18, 2016 | ||
| Dupinder Kaur Sidhu | Corporate Officer | May 24, 2019 | |
| Corporate Director | Jul 13, 2022 | ||
| W-2 Managing Employee | May 24, 2019 | ||
| Operational/Managerial Control | May 24, 2019 | ||
| Central Valley Specialty Hospital Inc | 5% Or Greater Direct Ownership Interest | Sep 12, 2012 | 100% |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- General Acute Care Hospital
- Modesto, CA
- NPI 1578989703
5% Or Greater Direct Ownership Interest
-
- Gastroenterology Physician
- Turlock, CA
- NPI 1194780999
5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee
Practitioners & affiliated clinicians
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Modesto, CA
- NPI 1467695452
Long-term care hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349049600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1643068800000",
"number": "1134470156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 STANDIFORD AVE",
"address_2": "SUITE 4 PMB 214",
"city": "MODESTO",
"state": "CA",
"postal_code": "953500726",
"telephone_number": "209-576-2532",
"fax_number": "209-576-2598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 17TH ST",
"city": "MODESTO",
"state": "CA",
"postal_code": "953541209",
"telephone_number": "209-576-2532",
"fax_number": "209-576-2598"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTRAL VALLEY SPECIALTY HOSPITAL, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2012-10-01",
"last_updated": "2022-01-25",
"certification_date": "2022-01-25",
"status": "A",
"authorized_official_last_name": "THOMPSON",
"authorized_official_first_name": "TAMMY",
"authorized_official_middle_name": "JEAN",
"authorized_official_title_or_position": "VP FINANCE",
"authorized_official_telephone_number": "209-248-7851"
},
"taxonomies": [
{
"code": "174200000X",
"taxonomy_group": "",
"desc": "Meals",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Modesto, CA
- Central Valley Perfusion, Inc
- Central Valley Radiation Oncology
- Central Valley Specialty Hospital Inc
- Central Valley Specialty Hospital Inc
- Central Valley Specialty Hospital Inc
- Central Valley Therapeutic Alliance, Inc.
- Cep America - California
- Cep America - California
- Cep America - Psychiatry PC
- Cep America- Neurology, PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.