Individual provider Active NPI

Julie Kay Vaishampayan, MD MPH

  • Public Health & General Preventive Medicine Physician
  • Modesto, CA
National Provider Identifier
1346401080
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
C53831 Issued in CA
Practice address
917 Oakdale Rd
Modesto, CA 95355-4593
Phone
(209) 558-7700
Fax
(209) 558-8184
NPI assigned
Jun 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X C53831 CA
Public Health & General Preventive Medicine Physician 2083P0901X C53831 CA Primary

Addresses

Primary practice location

917 Oakdale Rd
Modesto, CA 95355-4593

Mailing address

917 Oakdale Rd
Modesto, CA 95355-4593
Phone (209) 558-7700

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
I20150511002400 CA Practitioner - Internal MedicinePractitioner - Preventive Medicine 0345317269 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53831CAMDDentist
C53831CAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Joaquin Behavioral Health Services CurrentSince Mar 18, 2015 Accepting new patients
County of San Joaquin CurrentSince Mar 18, 2015 Accepting new patients

Locations

300 W Oak St
Lodi, CA 95240
Phone (209) 331-7303

1601 E Hazelton Ave
Stockton, CA 95205
Phone (209) 468-3413

1212 N California St
Stockton, CA 95202
Phone (209) 468-8660

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDFGCA/Endpoint/JDFGCA

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1346401080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 OAKDALE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554593",
            "telephone_number": "209-558-7700",
            "fax_number": "209-558-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 OAKDALE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554593",
            "telephone_number": "209-558-7700",
            "fax_number": "209-558-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAISHAMPAYAN",
        "first_name": "JULIE",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "MD MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "C53831",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "C53831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.