NPIMap

Individual provider Active NPI

Dimple Ajwani, D.O.

  • Family Medicine Physician
  • Roseville, CA
National Provider Identifier
1053687152
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A12842 Issued in CA
Practice address
1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone
(916) 781-1927
NPI assigned
Mar 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 20A12842 CA
Family Medicine Physician 207Q00000X 20A12842 CA Primary

Addresses

Primary practice location

1 Medical Plaza Dr
Roseville, CA 95661-3037

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140320002249 CA Practitioner - Family PracticePractitioner - Hospitalist 2062643729 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical Foundation 2,473 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 454-6868

2800 L St
Sacramento, CA 95816-5616

Hospital & facility affiliations

  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A12842CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Trauma Physicians Billing Service Current Accepting new patients
Sutter Valley Medical Foundation Family Medicine Current Accepting new patients
Sutter Valley Medical Foundation Family Medicine CurrentSince Sep 21, 2020 Accepting new patients
John Muir Trauma Physicians Billing Service Family Medicine CurrentSince Nov 30, 2017 Accepting new patients
John Muir Health Past Accepting new patients
John Muir Health Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

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

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Interoperability endpoints

  • Direct secure messaging: dajwani204595@hisp.ehr.sutterhealth.org

Organizations & group practices 30

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.

View all 30

Hospital & facility affiliations 1

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": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1053687152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PLAZA DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613037",
            "telephone_number": "916-781-1927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJWANI",
        "first_name": "DIMPLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "20A12842",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A12842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.