Individual provider Active NPI

Pritpal S Randhawa, MD

  • Hospitalist Physician
  • Placerville, CA
National Provider Identifier
1063504348
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A83324 Issued in CA
Practice address
1100 Marshall Way
Placerville, CA 95667-6533
Phone
(530) 626-2787
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A83324 CA
Hospitalist Physician 208M00000X A83324 CA Primary

Addresses

Primary practice location

1100 Marshall Way
Placerville, CA 95667-6533

Mailing address

PO Box 45680
San Francisco, CA 94145-0680
Phone (530) 626-2787

Other identifiers 1

IdentifierTypeStateIssuer
00A833240MedicaidCA

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
I20081219000338 CA Practitioner - Internal Medicine 5991867251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians

Practice addresses (Care Compare)

1095 Marshall Way
Placerville, CA 95667-5722

Hospital & facility affiliations

  • Marshall Medical Center Hospital, Placerville, CA, CCN 050254
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83324CAMDPharmacist
A83324CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Medical Center Internal Medicine CurrentSince Nov 1, 2016 Accepting new patients
Marshall Medical Center Internal Medicine CurrentSince Nov 1, 2016 Accepting new patients
Dignity Health Past Accepting new patients
Dignity Community Care Past Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients
Dignity Health Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

3581 Palmer Dr
Ste 602
Cameron Park, CA 95682
Phone (530) 626-2920

1100 Marshall Way
Placerville, CA 95667
Phone (530) 626-2601

1095 Marshall Way
Placerville, CA 95667
Phone (530) 626-2920

1095 Marshall Way
Ste 201
Placerville, CA 95667
Phone (530) 344-5470

Organizations & group practices 7

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1063504348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45680",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941450680",
            "telephone_number": "530-626-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MARSHALL WAY",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676533",
            "telephone_number": "530-626-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDHAWA",
        "first_name": "PRITPAL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A83324",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A83324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A833240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.