Individual provider Active NPI

Gopika Gangupantula, MD

  • Family Medicine Physician
  • Modesto, CA
National Provider Identifier
1245318138
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A81025 Issued in CA
Practice address
1213 Coffee Rd Ste D
Modesto, CA 95355-4229
Phone
(209) 497-4677
Fax
(209) 300-7172
NPI assigned
Nov 1, 2006
Last updated
Nov 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A81025 CA Primary
Diabetology (Family Medicine) Physician 207QD0401X A81025 CA

Addresses

Primary practice location

1213 Coffee Rd Ste D
Modesto, CA 95355-4229

Mailing address

1213 Coffee Rd Ste D
Modesto, CA 95355-4229
Phone (209) 497-4677

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081126000394 CA Practitioner - Family Practice 0749340354 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1213 Coffee Rd
Suite D
Modesto, CA 95355-4229
Phone (209) 497-4677

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A81025CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Stanislaus CurrentSince Apr 1, 2020 Accepting new patients
County of Stanislaus Current Accepting new patients
County of Stanislaus CurrentSince Apr 1, 2020 Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Locations

1524 McHenry Ave
Ste 300
Modesto, CA 95350
Phone (209) 527-0615

1524 McHenry Ave
Ste 330
Modesto, CA 95350
Phone (209) 558-7085

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: valleydiabetesobesity.gopikagangupantula@137137.advancedmd-direct.com

Organizations & group practices 6

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

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1245318138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 COFFEE RD STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554229",
            "telephone_number": "209-497-4677",
            "fax_number": "209-300-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 COFFEE RD STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554229",
            "telephone_number": "209-497-4677",
            "fax_number": "209-300-7172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGUPANTULA",
        "first_name": "GOPIKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A81025",
            "primary": true
        },
        {
            "code": "207QD0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Diabetology",
            "state": "CA",
            "license": "A81025",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.