Individual provider Active NPI

Andrew T Huber, MD

  • Surgery Physician
  • Modesto, CA
National Provider Identifier
1316388325
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A134599 Issued in CA
Practice address
1552 Coffee Rd Ste 200
Modesto, CA 95355
Phone
(209) 248-7168
NPI assigned
Jul 8, 2013
Last updated
Feb 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A134599 CA Primary

Addresses

Primary practice location

1552 Coffee Rd Ste 200
Modesto, CA 95355

Mailing address

1552 Coffee Rd Ste 200
Modesto, CA 95355-3122
Phone (209) 248-7168

Other practice location 1

644 E Harding Way Ste B
Stockton, CA 95204-6103
Phone (209) 244-9191

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
I20200110001576 CA Practitioner - General SurgeryPractitioner - Other (Physician) 9133470610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Nebraska College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1552 Coffee Rd
Suite 200
Modesto, CA 95355-3122
Phone 2092487168151

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central California Bariatric Surgery, Partnership Surgery CurrentSince Jan 6, 2025 Accepting new patients
Central California Bariatric Surgery a Medical Corporation Surgery CurrentSince Nov 9, 2019 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

1001 Sylvan Ave
Ste A
Modesto, CA 95350
Phone (209) 248-7168

1552 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 248-7168

644 E Harding Way
Stockton, CA 95204

644 E Harding Way
Ste B
Stockton, CA 95204
Phone (209) 244-9191

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ahuber345363@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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 3

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": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1316388325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1552 COFFEE RD STE 200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553122",
            "telephone_number": "209-248-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 COFFEE RD STE 200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-248-7168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "644 E Harding Way Ste B",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952046103",
            "country_code": "US",
            "telephone_number": "209-244-9191",
            "fax_number": "209-244-9190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBER",
        "first_name": "ANDREW",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-08",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A134599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.