Individual provider Active NPI

Ede J Voorheis, PA-C

  • Medical Physician Assistant
  • Modesto, CA
National Provider Identifier
1134620263
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA55140 Issued in CA
Practice address
2101 Tenaya Dr
Modesto, CA 95354-3930
Phone
(209) 576-6766
Fax
(209) 576-6770
NPI assigned
Feb 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA55140 CA
Medical Physician Assistant 363AM0700X PA55140 CA Primary

Addresses

Primary practice location

2101 Tenaya Dr
Modesto, CA 95354-3930

Mailing address

1910 Customer Care Way
Atwater, CA 95301-5167
Phone (209) 384-6493

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
I20180907000534 CA Practitioner - Physician Assistant 0840540142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1409 E Briggsmore Ave
Modesto, CA 95355-2707
Phone (209) 524-1211

3612 Dale Rd
Modesto, CA 95356-0500
Phone (209) 522-0146

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

Hospital & facility affiliations

  • Sutter Care at Home Home health agency, Salida, CA, CCN 057695

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA55140CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Aug 1, 2022 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Aug 1, 2022 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

3612 Dale Rd
Modesto, CA 95356
Phone (209) 522-0146

Interoperability endpoints

  • Direct secure messaging: evoorheis413008@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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1134620263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 CUSTOMER CARE WAY",
            "city": "ATWATER",
            "state": "CA",
            "postal_code": "953015167",
            "telephone_number": "209-384-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 TENAYA DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953543930",
            "telephone_number": "209-576-6766",
            "fax_number": "209-576-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOORHEIS",
        "first_name": "EDE",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55140",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA55140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.