Active NPI
Maithili Udupa, M.D.
- Pediatrics Physician
- Modesto, CA
National Provider Identifier
1760128425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A205449
- Practice address
- 1510 Florida Ave
Modesto, CA 95350-4437 - Phone
- (209) 722-4842
- NPI assigned
- May 6, 2022
- Last updated
- Mar 6, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A205449 | CA | Primary |
Addresses
Primary practice location
1510 Florida Ave
Modesto, CA 95350-4437
Mailing address
1510 Florida Ave
Modesto, CA 95350-4437
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A205449 | CA | MD | Pediatrics Physician |
Interoperability endpoints
- mudupa18904@prd.direct.tbh.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772755200000",
"number": "1760128425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1510 FLORIDA AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953504437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1510 FLORIDA AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953504437",
"telephone_number": "209-722-4842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDUPA",
"first_name": "MAITHILI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-06",
"last_updated": "2026-03-06",
"certification_date": "2026-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A205449",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.