Valley Surgery Center at Modesto, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

VALLEY SURGERY CENTER AT MODESTO, LLC

Practice address

1300 Mable Ave
Suite 1
Modesto, CA 95355-1120

Phone

(209) 571-1633

Fax

(206) 491-0772

NPI assigned

Mar 3, 2006

Last updated

Nov 20, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eric Boon

Title

Officer/Authorized Official

Phone

(480) 567-0269

Specialties & licenses 1

Addresses

Other names 1

• VALLEY SURGERY CENTER, LP Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Valley Surgery Center LPCCN 05C0001659

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patrick Neal Rhoades, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Modesto, CA
  • NPI 1972568400
  NPD
• John F Cruikshank III, MD

  • Anesthesiology Physician
  • Manteca, CA
  • NPI 1679591010
  NPD (past)
• Jacqueline I Decayette, M.D.

  • Anesthesiology Physician
  • Modesto, CA
  • NPI 1942279914
  NPD (past)
• Charles Kim, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Stockton, CA
  • NPI 1104242924
  NPD (past)
• Gary A Schenck Jr., MD

  • Anesthesiology Physician
  • Stockton, CA
  • NPI 1093808818
  NPD (past)

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1235106782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MABLE AVE STE 1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551120",
            "telephone_number": "209-571-1633",
            "fax_number": "209-491-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MABLE AVE",
            "address_2": "SUITE 1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551120",
            "telephone_number": "209-571-1633",
            "fax_number": "206-491-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY SURGERY CENTER AT MODESTO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-03",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "480-567-0269"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VALLEY SURGERY CENTER, LP",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "VALLEY SURGERY CENTER, LP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Valley Psychiatric Professional Corporation (Valley Psychiatric Associates)
• Valley Recovery Resources (Redwood Family Center)
• Valley Recovery Resources
• Valley Recovery Resources (Redwood Family Center)
• Valley Subacute & Rehabilitation Center, LLC (Central Valley Post Acute, Modesto)
• Valley Wound Healing Center, Inc.
• Paula Kay Van Alen
• Donald Richard Van Bibber, D.D.S.
• Tracy Marie Van de Pol, BSN, CNOR, RNFA
• Sierra Darlene Van Etten

• Ambulatory Surgical Clinic/Center in Modesto, CA
• Providers in Modesto, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.