Modesto Specialty Surgery Center, PC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MODESTO SPECIALTY SURGERY CENTER, PC

Practice address

3105 McHenry Ave # 102
Modesto, CA 95350-1439

Phone

(800) 991-6448

Fax

(424) 369-9555

NPI assigned

Mar 25, 2014

Organization subpart

No

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

Authorized official

Name

Sheri Alley

Title

Director, Credentialing

Phone

(661) 388-5240

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Modesto Specialty Surgery Center PCCCN 05C0002109

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

Tax ID family

Modesto Specialty Surgery Center PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Modesto Specialty Surgery Center PC

  • Ambulatory Surgical Clinic/Center
  • Los Angeles, CA
  • NPI 1205177235
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Taheri, M.D.

  • Dermatology Physician
  • Los Angeles, CA
  • NPI 1992774681
  NPD (past)

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787616000000",
    "number": "1265859573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16297",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902092297",
            "telephone_number": "800-991-6448",
            "fax_number": "424-369-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 MCHENRY AVE # 102",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501439",
            "telephone_number": "800-991-6448",
            "fax_number": "424-369-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODESTO SPECIALTY SURGERY CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-25",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A",
        "authorized_official_last_name": "ALLEY",
        "authorized_official_first_name": "SHERI",
        "authorized_official_title_or_position": "DIRECTOR, CREDENTIALING",
        "authorized_official_telephone_number": "661-388-5240"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Modesto Radiological Medical Group, Inc.
• Modesto Radiology Imaging, Inc.
• Modesto Residential Living Center
• Modesto Senior Living Limited Partnership
• Modesto SNF Operations LLC
• Modesto Surgery Center
• Modesto Surgery Center LLC
• Modesto Surgical Associates
• Modesto Urgent Care Inc
• Modi Dental Corporation

• 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 Aug 25, 2026; 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.