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MODESTO PEDIATRICS
NPI 1366547796
Pediatrics in Modesto, CA

Active since September 13, 2006CLIA 05D1017797 · Waiver
3109 COFFEE RD, STE A, MODESTO, CA 95355(209) 522-0001(209) 549-7077 Get Directions Write a Review

NPPES record last updated: August 16, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Modesto Pediatrics NPPES

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

MODESTO PEDIATRICS (NPI 1366547796) is a healthcare organization registered as a pediatrics in Modesto, California and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through October 5, 2027 and lists Ann Marie Truscello, President, as its authorized official.

NPPES Registry Identity

NPI1366547796
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameMODESTO PEDIATRICS
Location Address3109 COFFEE RD, STE AModesto, CA 95355-1766
Mailing AddressPo Box 578202Modesto, CA 95357-8202 · (209) 522-0001 · Fax (209) 549-7077
Phone(209) 522-0001
Fax(209) 549-7077
Organization SubpartNo
Authorized OfficialAnn Marie TruscelloPresident · (209) 522-0001
Enumeration DateSeptember 13, 2006
Last NPPES UpdateAugust 16, 2011
✔ NPI 1366547796 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in CA · G68634✔ Licensed in CA · G83542
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.
3109 COFFEE RD, Modesto, CA 95355
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Other Identifiers 2

OtherZZZ07358ZCA · Blue Shield Group Pin
MedicaidGR0094690CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1017797

Modesto Pediatrics · Modesto, CA
Active · expires Oct 5, 2027
CLIA Number05D1017797
Laboratory TypePhysician Office
Certificate Effective DateOctober 6, 2025
Certificate Expiration DateOctober 5, 2027
Laboratory DirectorAnn Marie Truscello MD
Laboratory Phone(209) 522-0001
Laboratory LocationModesto Pediatrics3109 Coffee Rd, Suite A, Modesto, CA 95355
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

DENA ANN LENSER MD
Pediatrics
3109 COFFEE RD, STE A
MODESTO, CA 95355
Stanislaus County (209) 522-0001
BRIAN ALEXANDER LENSER MD
Ophthalmology
3109 COFFEE RD, STE C
MODESTO, CA 95355
Stanislaus County (209) 572-8528
ANN MARIE TRUSCELLO MD
Pediatrics
3109 COFFEE RD, STE A
MODESTO, CA 95355
Stanislaus County (209) 522-0001

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 Modesto Pediatrics's NPI number?

The NPI number for Modesto Pediatrics is 1366547796. It was assigned to this organization in the NPPES registry on September 13, 2006.

Where is Modesto Pediatrics located?

Modesto Pediatrics is located at 3109 Coffee Rd Ste A, Modesto, CA 95355. The listed phone number is (209) 522-0001.

What is Modesto Pediatrics's specialty?

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

Does Modesto Pediatrics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1017797) is associated with this NPI, valid through October 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Modesto Pediatrics was last updated on August 16, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.