Thadeo J Aceves, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA22255 Issued in CA

Practice address

1441 Florida Ave
Modesto, CA 95350-4404

Phone

(209) 576-3525

Fax

(209) 576-3544

NPI assigned

May 17, 2012

Last updated

Jan 13, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Hospitalists of Modesto Medical Group Inc

  • Internal Medicine Physician
  • Modesto, CA
  • NPI 1821190711
  Medicare reassignment
• Hospitalists of Modesto Medical Group

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1659712586
  NPD (past)

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1821358375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 MCHENRY AVE",
            "address_2": "STE 65B #259",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95350",
            "telephone_number": "209-576-3525",
            "fax_number": "209-383-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504404",
            "telephone_number": "209-576-3525",
            "fax_number": "209-576-3544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1114 6th St",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953542203",
            "country_code": "US",
            "telephone_number": "209-576-2845",
            "fax_number": "209-576-8842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACEVES",
        "first_name": "THADEO",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-17",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corina Acevedo
• Eva Acevedo
• Jessica Acevedo
• Laura Acevedo, B.A.
• Osiris Acevedo
• Nagui Achamallah, M.D.
• Joydev Acharya, MD
• Ariel Achazo
• Seth Ackuayi, MD
• Claudia Edith Acosta Canela, LMFT

• Physician Assistant in Modesto, CA
• Providers in Modesto, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.

Verify at the official NPI Registry.