NPIMap

Individual provider Active NPI

Shewit K Weldetensae, MD

  • Cardiovascular Disease Physician
  • Modesto, CA
National Provider Identifier
1972550150
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A88881 Issued in CA
Practice address
1540 Florida Ave 100
Modesto, CA 95350-4430
Phone
(209) 577-5557
Fax
(209) 579-7246
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Cardiology Physician 207UN0901X A88881 CA
Cardiovascular Disease Physician 207RC0000X A88881 CA Primary

Addresses

Primary practice location

1540 Florida Ave 100
Modesto, CA 95350-4430

Mailing address

1540 Florida Ave Ste 100
Modesto, CA 95350-4430
Phone (209) 577-5557

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ76734ZMedicaidCA

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
I20041118000907 CA Practitioner - Cardiovascular Disease (Cardiology) 1658335641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1991
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)

1000 Delbon Ave
Turlock, CA 95382-2008
Phone (209) 524-9401

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

1409 E Briggsmore Ave
Modesto, CA 95355-2707
Phone (209) 524-1211

1700 Coffee Rd
Modesto, CA 95355-2803
Phone (209) 526-4500

2800 L St
Sacramento, CA 95816-5616

3612 Dale Rd
Modesto, CA 95356-0500
Phone (209) 522-0146

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Modesto, CA, CCN 050557
  • Memorial Hospital Los Banos Hospital, Los Banos, CA, CCN 050528
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108
  • Doctors Medical Center Hospital, Modesto, CA, CCN 050464
  • Adventist Health Sonora Hospital, Sonora, CA, CCN 050335

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A88881CAMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Sep 1, 2022 Accepting new patients
Valley Heart Associates Medical Group Inc Cardiovascular Disease CurrentSince Oct 10, 2005 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Sep 1, 2022 Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Doctors Medical Center of Modesto PastSince Jan 17, 2021 Accepting new patients
Emanuel Medical Center, Inc. Past Accepting new patients
Doctors Hospital of Manteca, Inc. Past Accepting new patients

Locations

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

1540 Florida Ave
Ste 100
Modesto, CA 95350
Phone (209) 544-3236

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

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

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

1000 Delbon Ave
Turlock, CA 95382
Phone (209) 664-7700

1051 E Tuolumne Rd
Ste 101
Turlock, CA 95382
Phone (209) 632-2200

Interoperability endpoints

  • Direct secure messaging: sweldetensae95706@hisp.ehr.sutterhealth.org
  • Direct secure messaging: shewit.weldetensae.p107@direct.tenet.nextgenshare.com

Organizations & group practices 9

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 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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1972550150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 FLORIDA AVE STE 100",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504430",
            "telephone_number": "209-577-5557",
            "fax_number": "209-579-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 FLORIDA AVE 100",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504430",
            "telephone_number": "209-577-5557",
            "fax_number": "209-579-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELDETENSAE",
        "first_name": "SHEWIT",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "CA",
            "license": "A88881",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A88881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ76734Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.