Individual provider Active NPI

Rosie K Sandhu, NP

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1003995820
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71002270A Issued in IN
Practice address
5150 Shelbyville Rd
Indianapolis, IN 46237-2601
Phone
(317) 782-1577
Fax
(317) 535-1119
NPI assigned
Nov 3, 2006
Last updated
Feb 27, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71002270A IN Primary

Addresses

Primary practice location

5150 Shelbyville Rd
Indianapolis, IN 46237-2601

Mailing address

5150 Shelbyville Rd
Indianapolis, IN 46237-2601
Phone (317) 782-1577

Other identifiers 1

IdentifierTypeStateIssuer
200862770MedicaidIN

Other names 1

  • Kanwaldeep Kaur Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070524000408 IN Practitioner - Nurse Practitioner 8628175700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

640 Patrick PL
Suite B
Brownsburg, IN 46112-2214
Phone (317) 456-0411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71002270AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Primary Care LLC CurrentSince May 18, 2021 Accepting new patients
My Mobile MD Northern Indiana PastSince Aug 11, 2019 Accepting new patients

Locations

640 Patrick Pl
Ste B
Brownsburg, IN 46112
Phone (317) 443-4513

Organizations & group practices 2

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1003995820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 SHELBYVILLE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462372601",
            "telephone_number": "317-782-1577",
            "fax_number": "317-535-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 SHELBYVILLE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462372601",
            "telephone_number": "317-782-1577",
            "fax_number": "317-535-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHU",
        "first_name": "ROSIE",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71002270A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200862770",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KANWALDEEP",
            "last_name": "KAUR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.