Individual provider Active NPI

Kulendu Ghanshyam Vasavda, M.D.

  • Family Medicine Physician
  • Stockton, CA
National Provider Identifier
1245443654
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A49048 Issued in CA
Practice address
221 Tuxedo CT
Suite C
Stockton, CA 95204-5261
Phone
(209) 941-0149
Fax
(209) 941-2550
NPI assigned
May 8, 2007
Last updated
Jan 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A49048 CA Primary

Addresses

Primary practice location

221 Tuxedo CT
Suite C
Stockton, CA 95204-5261

Mailing address

221 Tuxedo CT
Suite C
Stockton, CA 95204-5261
Phone (209) 941-0149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1981
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

221 Tuxedo CT
Stockton, CA 95204-5261

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49048CAMDMarriage & Family Therapist
A49048CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kulendu G Vasavda MD Inc Family Medicine Past Accepting new patients
Roots of Addiction Counseling Center LLC Past Accepting new patients

Organizations & group practices 2

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 7

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1245443654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TUXEDO CT",
            "address_2": "SUITE C",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045261",
            "telephone_number": "209-941-0149",
            "fax_number": "209-941-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 TUXEDO CT",
            "address_2": "SUITE C",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045261",
            "telephone_number": "209-941-0149",
            "fax_number": "209-941-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASAVDA",
        "first_name": "KULENDU",
        "middle_name": "GHANSHYAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A49048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.