DR. RAUL MONTALVO M.D.
NPI 1518967488
Family Medicine in Modesto, CA

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

Active since July 21, 2005PECOS EnrolledAccepts Medicare Assignment

1541 FLORIDA AVE STE 200, MODESTO, CA 95350(209) 577-3388(209) 575-3085 Get Directions Write a Review

NPPES record last updated: January 24, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dr. Raul Montalvo M.d. NPPES

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

DR. RAUL MONTALVO M.D. (NPI 1518967488) is an individual family medicine provider in Modesto, California, licensed in California (A64247) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1996).

NPPES Registry Identity

NPI1518967488

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. RAUL MONTALVOCredential: M.D.

Location Address1541 FLORIDA AVE STE 200Modesto, CA 95350-4438

Mailing Address1541 Florida Ave Ste 200Modesto, CA 95350-4438 · (209) 577-3388 · Fax (209) 575-3085

Phone(209) 577-3388

Fax(209) 575-3085

Sole ProprietorNo

Medical School CMSOtherGraduated 1996

Enumeration DateJuly 21, 2005

Last NPPES UpdateJanuary 24, 2024

NPPES CertifiedJanuary 24, 2024

✔ NPI 1518967488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CA · A64247

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1541 FLORIDA AVE STE 200, Modesto, CA 95350

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Raul Montalvo M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7719040161

PECOS Enrollment IDI20101203001260

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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit, 20-29 minutes 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

125 services63 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

43 services43 patients

Established patient office or other outpatient visit, 30-39 minutes 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

42 services33 patients

New patient office or other outpatient visit, 45-59 minutes 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

11 services11 patients

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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers21 claims46 services$5.59 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 12

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

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