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DR. MAITHILI UDUPA M.D.
NPI 1760128425
Pediatrics in Modesto, CA

Active since May 06, 2022PECOS Enrolled
1510 FLORIDA AVE, MODESTO, CA 95350(209) 722-4842 Get Directions Write a Review

NPPES record last updated: March 6, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 6, 2026, Aug 18, 2022, May 6, 2022 (3 updates tracked since 2022).

About Dr. Maithili Udupa M.d. NPPES

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

DR. MAITHILI UDUPA M.D. (NPI 1760128425) is an individual pediatrics provider in Modesto, California, licensed in California (A205449) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1760128425
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. MAITHILI UDUPACredential: M.D.
Location Address1510 FLORIDA AVEModesto, CA 95350-4437
Mailing Address1510 Florida AveModesto, CA 95350-4437
Phone(209) 722-4842
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateMay 6, 2022
Last NPPES UpdateMarch 6, 20263 updates tracked since enumeration
NPPES CertifiedMarch 6, 2026
✔ NPI 1760128425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A205449
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
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Maithili Udupa M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5890253173
PECOS Enrollment IDI20260817003681
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 Reassignment

Medicare enrollment records show Maithili Udupa reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

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

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
KISHORE KUMAR GADDAM M.D
Pediatrics
1510 FLORIDA AVE
MODESTO, CA 95350
Stanislaus County (209) 722-4842
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

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 Maithili Udupa's NPI number?

The NPI number for Maithili Udupa is 1760128425. It was assigned to this individual provider in the NPPES registry on May 6, 2022.

Where is Maithili Udupa located?

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

What is Maithili Udupa's specialty?

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

Is Maithili Udupa enrolled in Medicare?

Yes. Maithili Udupa is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Maithili Udupa's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Maithili Udupa reassigns Medicare benefits to Golden Valley Health Center (Modesto, CA). The 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 Maithili Udupa's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Maithili Udupa was last updated on March 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.