NPIMap

Individual provider Active NPI

Anthony Rex Victorio, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Modesto, CA
National Provider Identifier
1659593606
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A86106 Issued in CA
Practice address
4301 Northstar Way
Modesto, CA 95356-9262
Phone
(209) 577-1200
Fax
(209) 577-6517
NPI assigned
May 2, 2007
Last updated
Feb 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X A86106 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A86106 CA Primary

Addresses

Primary practice location

4301 Northstar Way
Modesto, CA 95356-9262

Mailing address

4301 Northstar Way
Modesto, CA 95356-9262
Phone (209) 577-1200

Other practice location 1

4 Medical Plaza Suite 205
Roseville, CA 95661
Phone (209) 577-1200

Other identifiers 1

IdentifierTypeStateIssuer
A86106OtherCALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070913000395 CA Practitioner - Pathology 7618061243 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Loma Linda University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yosemite Pathology Medical Group IncGroup PAC ID 3072415751, 45 clinicians

Practice addresses (Care Compare)

4301 N Star Way
Suite a
Modesto, CA 95356-9262
Phone (209) 577-1200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
53.37 of 100Reported as group
Quality
41.06
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A86106CAMDCytopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capitol Gastroenterology Consultants Medical Group, Inc. CurrentSince Mar 1, 2021 Accepting new patients
Yosemite Pathology Medical Group, Inc Cytopathology CurrentSince Aug 1, 2007 Accepting new patients
Bay Pathology Medical Group Cytopathology Current Accepting new patients
Yosemite Pathology Medical Group, in Past Accepting new patients

Locations

3901 Lone Tree Way
Antioch, CA 94509
Phone (925) 779-7200

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

1205 E North St
Manteca, CA 95336
Phone (209) 239-8301

3172 Collins Dr
Ste B
Merced, CA 95348
Phone 2095771200220

1421 Oakdale Rd
Modesto, CA 95355
Phone (209) 572-0151

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1700 Coffee Rd
Modesto, CA 95355
Phone (209) 526-4500

4301 N Star Way
Modesto, CA 95356
Phone 2095771200 ext. 212

4301 N Star Way
Ste A
Modesto, CA 95356

730 17th St
Modesto, CA 95354
Phone (209) 248-7700

350 S Oak Ave
Oakdale, CA 95361
Phone (209) 847-3011

4 Medical Plaza Dr
Ste 205
Roseville, CA 95661
Phone (916) 773-6200

10 Woodland Rd
Saint Helena, CA 94574
Phone (707) 261-7821

768 Mountain Ranch Rd
San Andreas, CA 95249
Phone (209) 464-6422

6001 Norris Canyon Rd
San Ramon, CA 94583
Phone (925) 275-8273

1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803

1420 N Tracy Blvd
Tracy, CA 95376
Phone (209) 832-6018

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

Organizations & group practices 6

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1659593606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 NORTHSTAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569262",
            "telephone_number": "209-577-1200",
            "fax_number": "209-577-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 NORTHSTAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569262",
            "telephone_number": "209-577-1200",
            "fax_number": "209-577-6517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 MEDICAL PLAZA SUITE 205",
            "address_purpose": "LOCATION",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95661",
            "country_code": "US",
            "telephone_number": "209-577-1200",
            "fax_number": "209-577-6517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICTORIO",
        "first_name": "ANTHONY",
        "middle_name": "REX",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "CA",
            "license": "A86106",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A86106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A86106",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.