1. Home
  2. Directory
  3. California
  4. Modesto
  5. Pediatrics
  6. NPI Profile

KISHORE KUMAR GADDAM M.D
NPI 1093069411
Pediatrics in Modesto, CA

Active since November 07, 2012PECOS Enrolled
1510 FLORIDA AVE, MODESTO, CA 95350(209) 722-4842 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 1, 2025, Nov 24, 2023, Aug 10, 2016 (3 updates tracked since 2016).

About Kishore Kumar Gaddam M.d NPPES

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

KISHORE KUMAR GADDAM M.D (NPI 1093069411) is an individual pediatrics provider in Modesto, California, licensed in California (C201309) and active in the NPI registry since November 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093069411
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameKISHORE KUMAR GADDAMCredential: M.D
Location Address1510 FLORIDA AVEModesto, CA 95350-4437
Mailing Address1510 Florida AveModesto, CA 95350-4437 · (209) 722-4842
Phone(209) 722-4842
Sole ProprietorYes
Enumeration DateNovember 7, 2012
Last NPPES UpdateJuly 1, 20253 updates tracked since enumeration
NPPES CertifiedJuly 1, 2025
✔ NPI 1093069411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in CA · C201309✔ Licensed in DE · C10025067
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1510 FLORIDA AVE, Modesto, CA 95350
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Highmark Blue Cross Blue Shield Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kishore Kumar Gaddam M.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Kishore Gaddam reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Golden Valley Health Center
Same address
Federally Qualified Health Center (FQHC)
1510 FLORIDA AVE, SUITE B
Modesto, CA 95350
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Golden Valley Health Centers
  • 440 clinicians in this Medicare group
NPI 1033193610 (209) 549-7090
Choctaw Nation Of Oklahoma
1,403 mi
Primary Care
1801 CHUKKA HINA
Durant, OK 74701
  • Reassigned Medicare billing, Texas enrollment
  • 581 clinicians in this Medicare group
NPI 1396173449 (580) 920-2100

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95350 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GOLDEN VALLEY HEALTH CENTER
Clinic/Center (Federally Qualified Health Center (FQHC))
1510 FLORIDA AVE, SUITE B
MODESTO, CA 95350
Stanislaus County (209) 549-7090
GOLDEN VALLEY HEALTH CENTERS
Obstetrics & Gynecology
1510 FLORIDA AVE, SUITE B
MODESTO, CA 95350
Stanislaus County (209) 574-1367
HEATHER LEE MD
Pediatrics
1510 FLORIDA AVE
MODESTO, CA 95350
Stanislaus County (209) 492-7150
MOHAMED ASHKAR
Pediatrics
1510 FLORIDA AVE
MODESTO, CA 95350
Stanislaus County (209) 722-4842
BASSAM ALJOMARD MD
Pediatrics
1510 FLORIDA AVE
MODESTO, CA 95350
Stanislaus County (866) 682-4842
ALESSANDRA MARIE VALENZUELA PORFIDO PA-C
Physician Assistant
1510 FLORIDA AVE
MODESTO, CA 95350
Stanislaus County (866) 682-4842
DR. ELAINE JOY TUBAYAN SORIANO MD
Internal Medicine
1510 FLORIDA AVE, SUITE H
MODESTO, CA 95350
Stanislaus County (209) 574-1030
SANDRA LEE PEREZ LCSW
Social Worker (Clinical)
1510 FLORIDA AVE, SUITE H
MODESTO, CA 95350
Stanislaus County (209) 574-1030

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 Kishore Gaddam's NPI number?

The NPI number for Kishore Gaddam is 1093069411. It was assigned to this individual provider in the NPPES registry on November 7, 2012.

Where is Kishore Gaddam located?

Kishore Gaddam practices at 1510 Florida Ave, Modesto, CA 95350. The listed phone number is (209) 722-4842.

What is Kishore Gaddam's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Kishore Gaddam enrolled in Medicare?

Yes. Kishore Gaddam is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kishore Gaddam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kishore Gaddam reassigns Medicare benefits to 2 organizations: Golden Valley Health Center (Modesto, CA) and Choctaw Nation Of Oklahoma (Durant, OK). Each 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 Kishore Gaddam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kishore Gaddam accept?

Health plans from AmeriHealth Caritas Next and Highmark Blue Cross Blue Shield Delaware list Kishore Gaddam as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kishore Gaddam was last updated on July 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.