Individual provider Active NPI

Khushdeep Panaych

  • Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1063370484
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95038210 Issued in CA
Practice address
2119 N Laverne Ave
Fresno, CA 93727-8856
Phone
(559) 313-1753
NPI assigned
Jan 14, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 95038210 CA Primary

Addresses

Primary practice location

2119 N Laverne Ave
Fresno, CA 93727-8856

Mailing address

2119 N Laverne Ave
Fresno, CA 93727-8856
Phone (559) 313-1753

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95038210CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1768348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1063370484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 N LAVERNE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937278856",
            "telephone_number": "559-313-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 N LAVERNE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937278856",
            "telephone_number": "559-313-1753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANAYCH",
        "first_name": "KHUSHDEEP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-14",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95038210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.