ERIC S. BELLFORT (PA) – Physician Assistant, NPI 1073504403

ERIC S. BELLFORT (PA) is a healthcare provider. based in Modesto, California. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA14504 (CA). The NPI Number for ERIC S. BELLFORT (PA) is 1073504403

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
ERIC S. BELLFORT (PA)
NPI
1073504403
Phone
(209) 342-2300
Address
4301 NORTHSTAR WAY
Enumeration Date
3 November 2005
Last Update Date
18 November 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9286342574
Graduation Year
1997 (29 years ago)
PAC ID
9234236266
Group Practice PAC ID
7416393194
Professional Enrollment ID
I20201130000318
Address ID
AZ863266744CO450XXSTXX407
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

10,570 PHYSICIAN ASSISTANT in CA

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Provider Addresses for ERIC S. BELLFORT (PA)

  • 4301 NORTHSTAR WAY

    MODESTO, CA 953569262

    Phone: (209) 342-2300

    Fax: (209) 524-4240

    Type: Mailing

  • Eden Medical Center, 20103, Lake Chabot Road, Castro Valley, Alameda County, California, 94546, United States

    CASTRO VALLEY, CA 94546

    Phone: (209) 342-2300

    Fax: (209) 524-4240

    Type: Location

  • 1000 N HUMPHREYS ST

    FLAGSTAFF, AZ 860013136

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-11-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20201130000318IPhysician AssistantAZTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes462335$0
99203New patient office or other outpatient visit, 30-44 minutes325325$0
87804Detection test by immunoassay with direct visual observation for influenza virus19494$0
81003Automated urinalysis test10488$0
87811Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)8885$0
View full utilization report →

Insurance plans in this area (ZIP 95356)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416393194View full group profile
NameSpecialtyState
Physician AssistantAZ
Nurse PractitionerAZ
Nurse PractitionerAZ
Nurse PractitionerAZ
Physician AssistantVA
Physician AssistantAZ
Family PracticeAZ
Nurse PractitionerAZ
Nurse PractitionerAZ
Nurse PractitionerWY

Reviews

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Frequently asked questions

How do I look up ERIC S. BELLFORT (PA) by NPI?
Use NPI 1073504403 when you need to reference ERIC S. BELLFORT (PA) in forms, claims, or directories.
Is ERIC S. BELLFORT (PA) currently active in the NPI registry?
CMS-published data lists ERIC S. BELLFORT (PA) as an active registrant.
What does ERIC S. BELLFORT (PA) treat or focus on?
Patients typically see ERIC S. BELLFORT (PA) under the specialty Physician Assistant. Clinical services aligned with this taxonomy classification.
What location shows for ERIC S. BELLFORT (PA)?
We surface Modesto, California for ERIC S. BELLFORT (PA) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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