Individual provider Active NPI

Samreen Kaur Dhariwal, PA-C

  • Physician Assistant
  • Sacramento, CA
National Provider Identifier
1033979943
Registry record updated Jul 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65407 Issued in CA
Practice address
1442 Ethan Way Ste 100
Sacramento, CA 95825-2232
Phone
(916) 443-3299
NPI assigned
Mar 19, 2024
Last updated
Jul 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA65407 CA Primary

Addresses

Primary practice location

1442 Ethan Way Ste 100
Sacramento, CA 95825-2232

Mailing address

1442 Ethan Way Ste 100
Sacramento, CA 95825-2232
Phone (916) 443-3299

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250220002889 CA Practitioner - Physician Assistant 3779003777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cares Community HealthGroup PAC ID 2769418151, 45 clinicians

Practice addresses (Care Compare)

1500 21St St
Sacramento, CA 95811-5216
Phone (916) 443-3299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA65407CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cares Community Health CurrentSince Feb 12, 2025 Accepting new patients
Cares Community Health CurrentSince Feb 12, 2025 Accepting new patients

Locations

1442 Ethan Way
Sacramento, CA 95825
Phone (916) 443-3299

1442 Ethan Way
Ste 100
Sacramento, CA 95825
Phone (916) 443-3299

1500 21st St
Sacramento, CA 95811
Phone (916) 443-3299

Organizations & group practices 3

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": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752883200000",
    "number": "1033979943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 ETHAN WAY STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252232",
            "telephone_number": "916-443-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1442 ETHAN WAY STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252232",
            "telephone_number": "916-443-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHARIWAL",
        "first_name": "SAMREEN",
        "middle_name": "KAUR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2025-07-19",
        "certification_date": "2025-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.