Individual provider Active NPI

Gregory Clifton Tesluk, MD

  • Ophthalmology Physician
  • Modesto, CA
National Provider Identifier
1255351755
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
C418240 Issued in CA
Practice address
400 E Orangeburg Ave Ste 2
Modesto, CA 95350-5365
Phone
(209) 526-3000
Fax
(209) 526-3133
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Technician/Technologist 156FX1100X C41824 CA
Ophthalmology Physician 207W00000X C418240 CA Primary

Addresses

Primary practice location

400 E Orangeburg Ave Ste 2
Modesto, CA 95350-5365

Mailing address

3424 Wycliffe Dr
Modesto, CA 95355-4742
Phone (209) 526-5121

Other identifiers 1

IdentifierTypeStateIssuer
00C418240MedicaidCA

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C41824CAMDOphthalmic Technician/Technologist
C418240CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Modesto Surgery Center LLC PastSince Sep 30, 2007 Accepting new patients

Organizations & group practices 1

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1255351755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 WYCLIFFE DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554742",
            "telephone_number": "209-526-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E ORANGEBURG AVE STE 2",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505365",
            "telephone_number": "209-526-3000",
            "fax_number": "209-526-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESLUK",
        "first_name": "GREGORY",
        "middle_name": "CLIFTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "CA",
            "license": "C41824",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C418240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C418240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.