Active NPI
Jasdeep Singh Sandhu, PA-C
- Physician Assistant
- Vancouver, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA60953038
- Practice address
- 501 SE 172ND Ave Ste 220
Vancouver, WA 98684-9542 - Phone
- (360) 882-2778
- Fax
- (360) 604-1717
- NPI assigned
- Sep 15, 2016
- Last updated
- Jul 23, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA189762 | OR | |
| Physician Assistant | 363A00000X | PA60953038 | WA | Primary |
Addresses
Primary practice location
501 SE 172ND Ave Ste 220
Vancouver, WA 98684-9542
Mailing address
700 NE 87TH Ave
Vancouver, WA 98664-4896
Phone (360) 882-2778
Other practice location 1
2730 SW Moody Ave
Cl5Pa
Portland, OR 97201-5042
Phone (425) 315-3485
Other practice location 2
2850 SE Powell Valley Rd
Gresham, OR 97080
Phone (503) 666-5050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2109002 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Oregon Health Sciences University School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2005 W Main St
Battle Ground, WA 98604-4311
Phone (360) 882-2778
501 SE 172ND Ave
Vancouver, WA 98684-9542
Phone (360) 882-2778
700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA189762 | OR | MD | Physician Assistant |
| PA60953038 | WA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Vancouver Clinic Inc PS | Current | Accepting new patients | |
| The Vancouver Clinic Inc PS | Current | Accepting new patients | |
| The Vancouver Clinic Pharmacy | Past | Accepting new patients |
Locations
2005 W Main St
Ste 220
Battle Ground, WA 98604
501 SE 172nd Ave
Ste 220
Vancouver, WA 98684
700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500
Organizations & group practices 4
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.
-
dba The Vancouver Clinic
- Internal Medicine Physician
- Vancouver, WA
- NPI 1992759427
-
- Clinic/Center
- Portland, OR
- NPI 1902827272
-
dba Salmon Creek 2 Ambulatory Surgery Center
- Ambulatory Surgical Clinic/Center
- Vancouver, WA
- NPI 1306556907
-
- Pharmacist
- Vancouver, WA
- NPI 1336365857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563840000000",
"number": "1043768377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 NE 87TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986644896",
"telephone_number": "360-882-2778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 SE 172ND AVE STE 220",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986849542",
"telephone_number": "360-882-2778",
"fax_number": "360-604-1717"
}
],
"practiceLocations": [
{
"address_1": "2730 SW Moody Ave",
"address_2": "CL5PA",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972015042",
"country_code": "US",
"telephone_number": "425-315-3485",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2850 SE Powell Valley Rd",
"address_purpose": "LOCATION",
"city": "Gresham",
"state": "OR",
"postal_code": "97080",
"country_code": "US",
"telephone_number": "503-666-5050",
"fax_number": "503-666-1162",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANDHU",
"first_name": "JASDEEP",
"middle_name": "SINGH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-15",
"last_updated": "2019-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA189762",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA60953038",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2109002",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.