VIRGINIA INTHAVONG FNP
NPI 1932741139
Nurse Practitioner - Family in Modesto, CA

Q: What is Virginia Inthavong's NPI number?

The NPI number for Virginia Inthavong is 1932741139. It was assigned to this individual provider in the NPPES registry on October 9, 2019.

Q: What is Virginia Inthavong's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since October 09, 2019PECOS EnrolledAccepts Medicare Assignment

1717 LAS VEGAS ST, MODESTO, CA 95358(866) 682-4842(866) 234-5550 Get Directions Write a Review

NPPES record last updated: February 22, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 22, 2022, May 5, 2020, Oct 9, 2019 (3 updates tracked since 2019).

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About Virginia Inthavong Fnp NPPES

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

VIRGINIA INTHAVONG FNP (NPI 1932741139) is an individual family provider in Modesto, California, licensed in California (95013866) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1932741139

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameVIRGINIA INTHAVONGCredential: FNP

Location Address1717 LAS VEGAS STModesto, CA 95358-5500

Mailing Address2012 Landing CtModesto, CA 95357-0857

Phone(866) 682-4842

Fax(866) 234-5550

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateOctober 9, 2019

Last NPPES UpdateFebruary 22, 20223 updates tracked since enumeration

NPPES CertifiedFebruary 22, 2022

✔ NPI 1932741139 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95013866

Also ListedNurse PractitionerTaxonomy 363L00000X · License XXXXXX (KS)

1717 LAS VEGAS ST, Modesto, CA 95358

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Secondary Practice Locations 2

Location 113340 Metcalf AveOverland Park, KS 66213-2804 · Phone (913) 984-2020

Location 25304 Queal DrShawnee, KS 66203-1968 · Phone (913) 710-1557

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

Virginia Inthavong Fnp 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 ID8820320872

PECOS Enrollment IDI20210309002875

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95358 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 12

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

MECHELLE RENEE PEREA-RYAN FNP

Nurse Practitioner (Family)