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ORANGEBURG MEDICAL GROUP
NPI 1467595389
Surgery in Modesto, CA

Active since February 14, 2007CLIA 05D0964407 · Waiver
1448 FLORIDA AVE, MODESTO, CA 95350(209) 343-8126(209) 523-2566 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Orangeburg Medical Group NPPES

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

ORANGEBURG MEDICAL GROUP (NPI 1467595389) is a healthcare organization registered as a surgery in Modesto, California and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through July 15, 2027 and lists Arthur Lee Hill, Administrator, as its authorized official.

NPPES Registry Identity

NPI1467595389
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameORANGEBURG MEDICAL GROUP
Location Address1448 FLORIDA AVEModesto, CA 95350-4424
Mailing Address1448 Florida AveModesto, CA 95350-4424 · (209) 343-8126 · Fax (209) 523-2566
Phone(209) 343-8126
Fax(209) 523-2566
Organization SubpartNo
Authorized OfficialArthur Lee HillAdministrator · (206) 343-8126
Enumeration DateFebruary 14, 2007
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1467595389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedFamily MedicineTaxonomy 207Q00000X
1448 FLORIDA AVE, Modesto, CA 95350
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Other Identifiers 1

MedicaidGR0021000CA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Orangeburg Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Orangeburg Medical Group, which bills Medicare for the services they deliver. Of these, 7 practice at this address. They are listed nearest first.

Clinicians, nearest first (7)

Jose Banuelos, M.D.
Family Practice
NPI 1427158351
1448 FLORIDA AVE
Modesto, CA 95350
(209) 523-1884
✔ PECOSSame address
Christina Chan, M.D.
Family Practice
NPI 1710074000
1448 FLORIDA AVE
Modesto, CA 95350
(209) 523-1884
✔ PECOS✔ Accepts MedicareSame address
Alina Haider, MD
Family Practice
NPI 1982264230
1448 FLORIDA AVE
Modesto, CA 95350
(209) 523-1884
✔ PECOS✔ Accepts MedicareSame address
Miguel Hernandez, M.D.
Family Practice
NPI 1376643213
1448 FLORIDA AVE
Modesto, CA 95350
(209) 523-1884
✔ PECOS✔ Accepts MedicareSame address
Alex Mari, M.D.
Family Practice
NPI 1609976562
1448 FLORIDA AVE
Modesto, CA 95350
(209) 523-1884
✔ PECOS✔ Accepts MedicareSame address
Russell Porter, MD
Family Practice
NPI 1174545362
1448 FLORIDA AVE
Modesto, CA 95350
(209) 523-1884
✔ PECOS✔ Accepts MedicareSame address
Manmeet Shergill, M.D.
Family Practice
NPI 1184818031
1448 FLORIDA AVE
Modesto, CA 95350
(209) 523-1884
✔ PECOS✔ Accepts MedicareSame address

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

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 05D0964407

Orangeburg Medical Group · Modesto, CA
Active · expires Jul 15, 2027
CLIA Number05D0964407
Laboratory TypePhysician Office
Certificate Effective DateJuly 16, 2025
Certificate Expiration DateJuly 15, 2027
Laboratory DirectorRussell T. Porter
Laboratory Phone(209) 523-1884
Laboratory LocationOrangeburg Medical Group1448 Florida Ave, Modesto, CA 95350
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Orangeburg Medical Group's NPI number?

The NPI number for Orangeburg Medical Group is 1467595389. It was assigned to this organization in the NPPES registry on February 14, 2007.

Where is Orangeburg Medical Group located?

Orangeburg Medical Group is located at 1448 Florida Ave, Modesto, CA 95350. The listed phone number is (209) 343-8126.

What is Orangeburg Medical Group's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Orangeburg Medical Group enrolled in Medicare?

Yes. Orangeburg Medical Group is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Orangeburg Medical Group?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians, all in Family Practice, reassign their Medicare billing to Orangeburg Medical Group. 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. Of these, 7 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Orangeburg Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0964407) is associated with this NPI, valid through July 15, 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 Orangeburg Medical Group was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.