Modesto Gastroenterology Medical Corporation

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A45724 Issued in CA

Legal business name

MODESTO GASTROENTEROLOGY MEDICAL CORPORATION

Practice address

2336 Sylvan Ave
Suite a
Modesto, CA 95355-9211

Phone

(209) 338-0292

Fax

(209) 338-0298

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Elsakr Magdy, M.D.

Title

President

Phone

(209) 338-0292

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Interoperability endpoints

• Direct secure messaging: modestogi@directaddress.net

Practitioners 5

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

• Magdy Shoukry Elsakr, M.D.

  • Specialist
  • Modesto, CA
  • NPI 1184676785
  Medicare reassignment Care Compare group NPD
• Ted Farzaneh, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Aliso Viejo, CA
  • NPI 1225588510
  Medicare reassignment Care Compare group NPD
• Sumeet Minhas, NP

  • Nurse Practitioner
  • Fresno, CA
  • NPI 1780371914
  Medicare reassignment NPD
• Eva Lili Padilla, NP

  • Family Nurse Practitioner
  • Modesto, CA
  • NPI 1700222627
  Medicare reassignment NPD
• Ranjeet N/a Kaur, FNP

  • Family Nurse Practitioner
  • Modesto, CA
  • NPI 1730997438
  NPD

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1881748846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2336 SYLVAN AVE",
            "address_2": "SUITE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953559211",
            "telephone_number": "209-338-0292",
            "fax_number": "209-338-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2336 SYLVAN AVE",
            "address_2": "SUITE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953559211",
            "telephone_number": "209-338-0292",
            "fax_number": "209-338-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODESTO GASTROENTEROLOGY MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "MAGDY",
        "authorized_official_first_name": "ELSAKR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-338-0292",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A45724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "DD2244",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ModestoGI@directaddress.net",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "xml",
            "address_1": "2336 Sylvan Ave",
            "address_2": "Suite A",
            "city": "Modesto",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953559211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ModestoGI@directaddress.net",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "xml",
            "address_1": "2336 Sylvan Ave Ste A",
            "city": "Modesto",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953559211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Modesto City Schools
• Modesto Dermatology and Skin Cancer PC
• Modesto Drug LLC
• Modesto Eye Center Inc
• Modesto Fire Department
• Modesto Gospel Mission
• Modesto Hearing Aid Center
• Modesto Kidney Center, Inc.
• Modesto Kidney Center, LLC
• Modesto Kidney Medical Group

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.