Individual provider Active NPI

Jagminder Singh Bhalla, M.D.

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1003879743
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A25813 Issued in CA
Practice address
1781 W Romneya Dr
Ste C
Anaheim, CA 92801-1818
Phone
(714) 956-3160
Fax
(714) 956-1188
NPI assigned
Apr 11, 2006
Last updated
Oct 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A25813 CA Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A25813 CA
Pulmonary Disease Physician 207RP1001X A25813 CA

Addresses

Primary practice location

1781 W Romneya Dr
Ste C
Anaheim, CA 92801-1818

Mailing address

1781 W Romneya Dr
Ste C
Anaheim, CA 92801-1818
Phone (714) 956-3160

Other identifiers 2

IdentifierTypeStateIssuer
GR0021080MedicaidCA
CM972AOtherCAMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091208000446 CA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 6507925526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A25813CAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anaheim Memorial Medical Center Past Accepting new patients
University of California Irvine Past Accepting new patients
Anaheim Global Medical Center, Inc Past Accepting new patients
Pulmonary Disease CT Internal Medicine PastSince Oct 1, 2009 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1003879743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1781 W ROMNEYA DR",
            "address_2": "STE C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011818",
            "telephone_number": "714-956-3160",
            "fax_number": "714-956-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 W ROMNEYA DR",
            "address_2": "STE C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011818",
            "telephone_number": "714-956-3160",
            "fax_number": "714-956-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHALLA",
        "first_name": "JAGMINDER",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A25813",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A25813",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A25813",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0021080",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "CM972A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.