| Scenic Faculty Medical Group, Inc. | |
|
1031 15th St Ste 6 Modesto CA 95354-1131 | |
| (209) 567-2361 | |
| Not Available |
| Full Name | Scenic Faculty Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1031 15th St Ste 6, Modesto, California |
| Authorized Official Name and Position | Linda Simpson (CREDENTIALING MANAGER) |
| Authorized Official Contact | 2095672361 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scenic Faculty Medical Group, Inc. 1031 15th St Ste 6 Modesto CA 95354-1131 Ph: (209) 567-2361 | Scenic Faculty Medical Group, Inc. 1031 15th St Ste 6 Modesto CA 95354-1131 Ph: (209) 567-2361 |
| NPI Number | 1275559411 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 08/28/2024 |
| Medicare PECOS PAC ID | 3870487838 |
|---|---|
| Medicare Enrollment ID | O20040210001195 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275559411 | NPI | - | NPPES |
| GR0084465 | Medicaid | CA | |
| GR0084460 | Medicaid | CA | |
| GR0084461 | Medicaid | CA | |
| GR0084462 | Medicaid | CA | |
| GR0084464 | Medicaid | CA | |
| GR0084466 | Medicaid | CA | |
| GR0084463 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (California) | Primary |
| Provider Name | Susan F Kraus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194708412 PECOS PAC ID: 0446145072 Enrollment ID: I20040220000841 |
| Provider Name | Ana R Revilla |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083792501 PECOS PAC ID: 5193789006 Enrollment ID: I20041118001159 |
| Provider Name | Susie Wenstrup |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013020288 PECOS PAC ID: 0749202778 Enrollment ID: I20051219000781 |
| Provider Name | James A Kraus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477580595 PECOS PAC ID: 5890798540 Enrollment ID: I20060817000584 |
| Provider Name | Nancy Brown |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477560290 PECOS PAC ID: 4385725217 Enrollment ID: I20080117000255 |
| Provider Name | John English |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437169224 PECOS PAC ID: 8325129158 Enrollment ID: I20080117000309 |
| Provider Name | Juan Lopez Solorza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295747152 PECOS PAC ID: 6507947348 Enrollment ID: I20080117000411 |
| Provider Name | Peter Gaines |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912915380 PECOS PAC ID: 9133157910 Enrollment ID: I20080118000523 |
| Provider Name | Thomas Wenstrup |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447268966 PECOS PAC ID: 0547342008 Enrollment ID: I20080123000708 |
| Provider Name | Mitchell A Cohen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063429843 PECOS PAC ID: 5193895902 Enrollment ID: I20080605000667 |
| Provider Name | Robert Mcgrew |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972558930 PECOS PAC ID: 8921168972 Enrollment ID: I20081120000216 |
| Provider Name | Elizabeth Anne Buhler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104176999 PECOS PAC ID: 0547493694 Enrollment ID: I20140425001537 |
| Provider Name | Baltej Dosanjh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346536711 PECOS PAC ID: 1658596150 Enrollment ID: I20140625001008 |
| Provider Name | Anika Godhwani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275829756 PECOS PAC ID: 4486879483 Enrollment ID: I20140708000607 |
| Provider Name | Christine Battaglia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558657106 PECOS PAC ID: 5597981449 Enrollment ID: I20140729002475 |
| Provider Name | Mohan S Sakhrani |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780879056 PECOS PAC ID: 6507000163 Enrollment ID: I20140918002379 |
| Provider Name | Raeleigh Payanes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346503224 PECOS PAC ID: 6305150947 Enrollment ID: I20150727002536 |
| Provider Name | Sunita Saini |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689839854 PECOS PAC ID: 4486947181 Enrollment ID: I20160718001918 |
| Provider Name | Nicole Mclawrence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740627397 PECOS PAC ID: 2769600329 Enrollment ID: I20170907001808 |
| Provider Name | Alexander Phan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750796371 PECOS PAC ID: 4284852849 Enrollment ID: I20180130001597 |
| Provider Name | Tana Seneewong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447786587 PECOS PAC ID: 1254755713 Enrollment ID: I20200717000244 |
| Provider Name | Amanda L Jamal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982137212 PECOS PAC ID: 0941627418 Enrollment ID: I20200828001169 |
| Provider Name | Meaghan Victoria Kingsley-teem |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740711332 PECOS PAC ID: 1759708225 Enrollment ID: I20200828001203 |
| Provider Name | Karen Ann P Rayos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114300209 PECOS PAC ID: 5496165615 Enrollment ID: I20201029001004 |
| Provider Name | Nancy E Cisneros |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104414598 PECOS PAC ID: 6901211556 Enrollment ID: I20210212002053 |
| Provider Name | Saira Dar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366412165 PECOS PAC ID: 7911949540 Enrollment ID: I20220113002127 |
| Provider Name | Flor De Maria Lopez Flores |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093277345 PECOS PAC ID: 9931582301 Enrollment ID: I20220817002667 |
| Provider Name | Andrea Silva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942792007 PECOS PAC ID: 4284024522 Enrollment ID: I20230309002679 |
| Provider Name | Adrienne Hong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366079337 PECOS PAC ID: 5092161281 Enrollment ID: I20231024002873 |
Tushar R. Modi, M.d. Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 413 E Orangeburg Ave Ste A, Modesto, CA 95350 Phone: 209-529-9600 Fax: 209-544-2620 | |
Golden Valley Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1510 Florida Ave, Suite B, Modesto, CA 95350 Phone: 209-549-7090 Fax: 209-549-7099 | |
Golden Valley Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1114 6th St, Modesto, CA 95354 Phone: 209-576-2845 Fax: 209-384-3966 | |
Golden Valley Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1121 Hammond St, Modesto, CA 95351 Phone: 209-576-4437 Fax: 209-384-3966 | |
Greater Modesto Medical Surgical Associates, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3125 Conant Ave, Modesto, CA 95350 Phone: 209-214-7053 Fax: 209-523-0764 | |
Gettysburg Medical Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1130 Coffee Rd, Building 10, Modesto, CA 95355 Phone: 209-725-2060 Fax: 209-725-2072 | |
Keith Leibowitz M.d. A Professional Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 203 Park Ave, Modesto, CA 95354 Phone: 757-645-7079 |