Individual provider Active NPI

Rupali Chaitanya Mahida, NP

  • Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1245823822
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95016695 Issued in CA
Practice address
1317 Oakdale Rd Ste 440
Modesto, CA 95355-3364
Phone
(209) 522-3362
NPI assigned
Feb 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95016695 CA Primary

Addresses

Primary practice location

1317 Oakdale Rd Ste 440
Modesto, CA 95355-3364

Mailing address

1317 Oakdale Rd Ste 440
Modesto, CA 95355-3364
Phone (209) 522-3362

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
I20210427001794 CA Practitioner - Nurse Practitioner 6709294903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1317 Oakdale Rd
Suite 440
Modesto, CA 95355-3364
Phone (209) 522-3362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Medical Care a Professional Corporation CurrentSince Mar 1, 2021 Accepting new patients
Family First Medical Care a Professional Corporation CurrentSince Mar 1, 2021 Accepting new patients

Locations

1317 Oakdale Rd
Ste 440
Modesto, CA 95355
Phone (209) 522-3362

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1245823822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 OAKDALE RD STE 440",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553364",
            "telephone_number": "209-522-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 OAKDALE RD STE 440",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553364",
            "telephone_number": "209-522-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHIDA",
        "first_name": "RUPALI",
        "middle_name": "CHAITANYA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95016695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.