DR. AMOD TENDULKAR (MD) – Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician, NPI 1457511628

DR. AMOD TENDULKAR (MD) is a healthcare provider. based in Stockton, California. specializing in CARDIAC SURGERY, THORACIC SURGERY, VASCULAR SURGERY. They hold the professional credentials MD. They hold a License No. A81369 (CA). The NPI Number for DR. AMOD TENDULKAR (MD) is 1457511628

Main info

Male
Sole Proprietor
25 Years Of Experience
Accepts Medicare Assignment
Name
DR. AMOD TENDULKAR (MD)
NPI
1457511628
Phone
(209) 948-1234
Address
1617 N CALIFORNIA ST
Enumeration Date
11 June 2008
Last Update Date
4 February 2022

Doctor Profile

Medical School Name
SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
4088511000
Graduation Year
2001 (25 years ago)
PAC ID
0941239388
Group Practice PAC ID
8921910225
Professional Enrollment ID
I20050805000831
Address ID
CA950515173SA710XXWAYX400

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness85
Years active:18State licenses:1Other namesUpdated within 12 months

262 CARDIAC SURGERY in CA

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Provider Addresses for DR. AMOD TENDULKAR (MD)

  • 1617, California Street, Stockton, San Joaquin County, California, 95204, United States

    SUITE 1D

    STOCKTON, CA 952046117

    Phone: (209) 948-1234

    Type: Mailing

  • 710 LAWRENCE EXPY DEPT 342

    SANTA CLARA, CA 950515173

    Phone: (408) 851-3779

    Fax: (408) 851-3862

    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: 2005-08-05

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
I20050805000831ICardiac SurgeryCATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95204)

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Provider's Procedures

DR. AMOD TENDULKAR (MD) performs procedures in CARDIAC SURGERY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIAC SURGERYCA33518Combined multiple vein and artery heart artery bypasses1313

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: 8921910225View full group profile
NameSpecialtyState
Emergency MedicineDC
Colorectal Surgery (Proctology), General SurgeryLA
-CA
N E U R O S U R G E R YMA
Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
Emergency MedicineCA
-MA
Emergency MedicineCA

Reviews

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Frequently asked questions

What number should I use to identify DR. AMOD TENDULKAR (MD) for billing?
Administrative and clinical systems typically use NPI 1457511628 for DR. AMOD TENDULKAR (MD).
Is DR. AMOD TENDULKAR (MD) currently accepting referrals based on NPI status?
Registry metadata lists DR. AMOD TENDULKAR (MD) as active.
What services align with DR. AMOD TENDULKAR (MD)'s listing?
DR. AMOD TENDULKAR (MD)'s public classification highlights Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician. Clinical services aligned with this taxonomy classification.
What city is tied to DR. AMOD TENDULKAR (MD)?
The directory associates DR. AMOD TENDULKAR (MD) with Stockton, California. Check all listed addresses for suites or satellite offices.
Can I export DR. AMOD TENDULKAR (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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