Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1093069411 Individual Practitioner Male Practitioner

Dr. Kishore Kumar Gaddam , MD

Pediatrics • Modesto, CA

Professional Overview & Biography Verified Profile Summary

Dr. Kishore Gaddam, MD is a registered healthcare professional specializing in Pediatrics in Modesto, CA. Practice services are available at 1510 FLORIDA AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1510 Florida Ave

Modesto, CA 953504437

Telephone 2097224842
Associated Practice Facility / Clinic
🏢 Golden Valley Health Center Facility NPI 1033193610

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Modesto, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.5 Yrs
State Avg: 22.5 Yrs
Regional Practice Density
77 Specialists

Practicing in Modesto, CA (9612 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-07-01
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License CA C201309

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.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License DE C10025067

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003957895

Doctor of Medicine (M.D.)

Jessica Hurtado

Health Educator

NPI 1013716026
Sarah Griffiths

Nurse Practitioner

NPI 1023559937
Janise Roebuck , NP

Nurse Practitioner - Family

NPI 1023651080

Nurse Practitioner

Christina Manguerra , LCSW

Social Worker - Clinical

NPI 1053201293

Licensed Clinical Social Worker

Ferris Powell

Nurse Practitioner - Family

NPI 1083205835

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location July 01, 2025

Registered at 1510 FLORIDA AVE, MODESTO, CA 953504437 (Tel: 2097224842)

📍
Updated Business Mailing Address July 01, 2025

Registered at 1510 FLORIDA AVE, MODESTO, CA 953504437 (Tel: 2097224842)

📍
Updated Practice Location November 24, 2023

Registered at 21141 STERLING AVE UNIT 1, GEORGETOWN, DE 199475571 (Tel: 3028566967)

📍
Updated Business Mailing Address November 24, 2023

Registered at 21141 STERLING AVE UNIT 1, GEORGETOWN, DE 199475571 (Tel: 3028566967)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 24, 2023

Pediatrics (License #C10025067 in DE)

NPI Profile Active August 10, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location August 10, 2016

Registered at 902 E LINCOLN RD, IDABEL, OK 747457337 (Tel: 5802862600)

📍
Updated Business Mailing Address August 10, 2016

Registered at 902 E LINCOLN RD, IDABEL, OK 747457337 (Tel: 5802862600)

👤
Provider Name / Credentials Updated August 10, 2016

Recorded as KISHORE GADDAM, M.D

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 10, 2016

Pediatrics (License #E8856 in AR)

🟢
Initial NPI Registration & Enumeration November 07, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1093069411
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 07, 2012
Last Update: July 01, 2025
Sole Proprietor: Yes

Mailing Address

1510 Florida Ave

Modesto, CA 953504437

Phone: 2097224842

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.