GETTYSBURG MEDICAL CLINIC INC
NPI 1033580931
Clinic/Center - Primary Care in Modesto, CA

Active since October 18, 2015
1130 COFFEE RD, BUILDING 10, MODESTO, CA 95355(209) 725-2060(209) 725-2072 Get Directions Write a Review

NPPES record last updated: October 18, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Gettysburg Medical Clinic Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GETTYSBURG MEDICAL CLINIC INC (NPI 1033580931) is a healthcare organization registered as a primary care in Modesto, California and active in the NPI registry since October 2015. The organization lists Grace Wee Lim, President, as its authorized official.

NPPES Registry Identity

NPI1033580931
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameGETTYSBURG MEDICAL CLINIC INC
Location Address1130 COFFEE RD, BUILDING 10Modesto, CA 95355-4228
Mailing AddressPo Box 26180Fresno, CA 93729-6180 · (209) 725-2060 · Fax (209) 725-2072
Fax(209) 725-2072
Organization SubpartNo
Authorized OfficialGrace Wee LimPresident · (209) 725-2060
Enumeration DateOctober 18, 2015
✔ NPI 1033580931 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
1130 COFFEE RD, Modesto, CA 95355

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gettysburg Medical Clinic Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20121128000353Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Gettysburg Medical Clinic Inc, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (4)

Internal Medicine
NPI 1740295419
5088 N FRESNO ST STE 104
Fresno, CA 93710
(559) 222-9362
✔ PECOS✔ Accepts Medicare88 mi
Nurse Practitioner
NPI 1316946874
5088 N FRESNO ST
Fresno, CA 93710
(559) 632-3006
✔ PECOS88 mi
Allergy/Immunology
NPI 1437256211
5088 N FRESNO ST
Fresno, CA 93710
(559) 244-6360
✔ PECOS✔ Accepts Medicare88 mi
Nurse Practitioner
NPI 1205910510
973 FRANKLIN AVE
Apo, AP 93246
(559) 998-2016
✔ PECOS113 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gettysburg Medical Clinic Inc's NPI number?

The NPI number for Gettysburg Medical Clinic Inc is 1033580931. It was assigned to this organization in the NPPES registry on October 18, 2015.

Where is Gettysburg Medical Clinic Inc located?

Gettysburg Medical Clinic Inc is located at 1130 Coffee Rd Building 10, Modesto, CA 95355. The listed phone number is (209) 725-2060.

What is Gettysburg Medical Clinic Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Gettysburg Medical Clinic Inc enrolled in Medicare?

Yes. Gettysburg Medical Clinic Inc is registered in the Medicare PECOS enrollment system.

When is Gettysburg Medical Clinic Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Gettysburg Medical Clinic Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Gettysburg Medical Clinic Inc, in Allergy/Immunology, Internal Medicine and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Gettysburg Medical Clinic Inc was last updated on October 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.