Individual provider Active NPI

Raman S Grewal, MD

  • Anesthesiology Physician
  • Henderson, NV
National Provider Identifier
1023000270
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A77029 Issued in CA
Practice address
129 W Lake Mead Pkwy
B-18
Henderson, NV 89015-7055
Phone
(702) 564-4440
Fax
(702) 558-1522
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 10879 NV
Anesthesiology Physician 207L00000X A77029 CA Primary

Addresses

Primary practice location

129 W Lake Mead Pkwy
B-18
Henderson, NV 89015-7055

Mailing address

129 W Lake Mead Pkwy
B-18
Henderson, NV 89015-7055
Phone (702) 564-4440

Other identifiers 1

IdentifierTypeStateIssuer
1023000270MedicaidNV

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
I20090108000082 CA Practitioner - Anesthesiology 3577542224 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York Medical College, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Services of San Joaquin PCGroup PAC ID 4082754056, 75 clinicians
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

1800 N California St
Stockton, CA 95204-6019
Phone (209) 943-2000

975 S Fairmont Ave
Lodi, CA 95240-5118
Phone (209) 334-3411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A77029CAMDAnesthesiology Physician
10879NVMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Mar 1, 2019 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Feb 1, 2019 Accepting new patients
Anesthesia Services of San Joaquin, P.C. Anesthesiology CurrentSince Apr 25, 2023 Accepting new patients
Sutter Valley Medical Foundation Anesthesiology Current Accepting new patients
Cep America - Anesthesia, PC Anesthesiology Current Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Feb 1, 2019 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Mar 1, 2019 Accepting new patients
Cep America - Anesthesia PC Anesthesiology Past Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

521 S Ham Ln
Lodi, CA 95242
Phone (209) 333-0905

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

525 W Acacia St
Stockton, CA 95203
Phone (209) 944-5410

Organizations & group practices 9

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1023000270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 W LAKE MEAD PKWY",
            "address_2": "B-18",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157055",
            "telephone_number": "702-564-4440",
            "fax_number": "702-558-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 W LAKE MEAD PKWY",
            "address_2": "B-18",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157055",
            "telephone_number": "702-564-4440",
            "fax_number": "702-558-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "RAMAN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "10879",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A77029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023000270",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.