Physicians Surgery Center of Modesto LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0557938 Issued in CA

Legal business name

PHYSICIANS SURGERY CENTER OF MODESTO LLC

Doing business as

River Surgical Institute

Practice address

609 E Orangeburg Ave # B
Modesto, CA 95350-5580

Phone

(209) 527-6700

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Eric Boon

Title

Market President

Phone

(480) 567-0269

Specialties & licenses 1

Addresses

Other names 1

• River Surgical Institute Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Physicians Surgery Center of Modesto Inc Dba River Surgical InstituteCCN 05C0001820

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

Practitioners 8

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

• John Joseph Casey, M.D.

  • Specialist
  • Modesto, CA
  • NPI 1811909716
  NPD (past)
• Robert Edward Caton, M.D.

  • Specialist
  • Modesto, CA
  • NPI 1861593196
  NPD (past)
• Jesua Israel Law, D.O.

  • Orthopaedic Surgery Physician
  • Modesto, CA
  • NPI 1487090049
  NPD (past)
• Jonathan Matthew Pettegrew, D.O.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Modesto, CA
  • NPI 1053552745
  NPD (past)
• William Louis Pistel, D.O.

  • Orthopaedic Surgery Physician
  • Modesto, CA
  • NPI 1518979418
  NPD (past)
• Marc A Trzeciak, D. O.

  • Orthopaedic Surgery Physician
  • Modesto, CA
  • NPI 1033111026
  NPD (past)
• Michael Wolterbeek, DPM

  • Podiatrist
  • Modesto, CA
  • NPI 1497767396
  NPD (past)
• Brad Aaron Zwahlen, M.D.

  • Specialist
  • Berkeley, CA
  • NPI 1508878406
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763510400000",
    "number": "1538280284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 E ORANGEBURG AVE BLDG B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505512",
            "telephone_number": "209-527-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 E ORANGEBURG AVE # B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505580",
            "telephone_number": "209-527-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS SURGERY CENTER OF MODESTO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "MARKET PRESIDENT",
        "authorized_official_telephone_number": "480-567-0269"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "0557938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "River Surgical Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Linda Sue Phillips, PA-C
• Shawna Phillips, SAC
• Gary W Phipps
• Amanda Phitsamay
• Jasmine Phol
• Nicole Picciotto, MD
• Martha Pichardo Lopez
• Garfield Cameron Pickell, M. D.
• Taylor Picker
• Josh Picus

• 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 Nov 19, 2025; 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.