Individual provider Active NPI

Victorio Parayno Pidlaoan, MD

  • Gastroenterology Physician
  • Modesto, CA
National Provider Identifier
1871813097
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A150228 Issued in CA
Practice address
1409 E Briggsmore Ave
Modesto, CA 95355-2707
Phone
(209) 524-1211
NPI assigned
Jun 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A150228 CA Primary

Addresses

Primary practice location

1409 E Briggsmore Ave
Modesto, CA 95355-2707

Mailing address

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 521-6097

Other practice location 1

5201 Harry Hines Blvd
Dallas, TX 75235-7708
Phone (214) 590-8058

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
I20170901001760 CA Practitioner - Gastroenterology 7810127032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Wayne State University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1011 Sylvan Ave
Suite C
Modesto, CA 95350-1693
Phone (209) 550-4780

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy185
Upper gastrointestinal (GI) endoscopy for acid reflux313

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Aug 16, 2017 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Aug 16, 2017 Accepting new patients
Texas Health Harris Methodist Hospital Fort Worth Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

1011 Sylvan Ave
Ste C
Modesto, CA 95350
Phone (209) 550-4740

1409 E Briggsmore Ave
Modesto, CA 95355
Phone (209) 550-4725

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

1401 Spanos Ct
Ste 104
Modesto, CA 95355
Phone (209) 525-3150

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

250 W Main St
Woodland, CA 95695
Phone (916) 668-6100

460 Plumas Blvd
Ste 202
Yuba City, CA 95991
Phone (530) 749-5500

Interoperability endpoints

  • Direct secure messaging: vpidlaoan376937@hisp.ehr.sutterhealth.org
  • FHIR API: https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1871813097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-521-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 E BRIGGSMORE AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552707",
            "telephone_number": "209-524-1211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5201 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752357708",
            "country_code": "US",
            "telephone_number": "214-590-8058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIDLAOAN",
        "first_name": "VICTORIO",
        "middle_name": "PARAYNO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A150228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.