Individual provider Active NPI

Gaganjit Sandhu, FNP

  • Family Nurse Practitioner
  • Brentwood, CA
National Provider Identifier
1083259899
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013758 Issued in CA
Practice address
100 Cortona Way Ste 160
Brentwood, CA 94513-7157
Phone
(925) 926-0195
NPI assigned
Nov 15, 2019
Last updated
Mar 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95013758 CA Primary
Emergency Registered Nurse 163WE0003X 828947 CA

Addresses

Primary practice location

100 Cortona Way Ste 160
Brentwood, CA 94513-7157

Mailing address

100 Cortona Way
Brentwood, CA 94513-7124
Phone (925) 926-0195

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
I20200310001343 CA Practitioner - Nurse Practitioner 9032547872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pain Clinics of Central California, Inc.Group PAC ID 0244615086, 19 clinicians

Practice addresses (Care Compare)

4505 Precissi LN
Suite a
Stockton, CA 95207-6240
Phone (833) 478-1818

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
27.23 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
90.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
828947CAMDEmergency Registered Nurse
95013758CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infusion Express of California Inc CurrentSince Jun 22, 2021 Accepting new patients
Pain Clinics of Central California, Inc. Pain Medicine CurrentSince May 20, 2022 Accepting new patients
Universal Healthcare Professional Medical PC PastSince Sep 9, 2016 Accepting new patients
Regenerative Spine, Pain, and Neuropathy Centers, Inc. PastSince Jun 22, 2021 Accepting new patients

Locations

4605 Buena Vista Rd
Ste 600815
Bakersfield, CA 93311

3751 E Shields Ave
Fresno, CA 93726
Phone (559) 272-1295

5771 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 272-1295

509 S I St
Ste B
Madera, CA 93637
Phone (559) 474-8445

1317 Oakdale Rd
Ste 800
Modesto, CA 95355
Phone (209) 284-0729

1801 Tully Rd
Ste F
Modesto, CA 95350
Phone (209) 526-5770

66 Bovet Rd
Ste 105
San Mateo, CA 94402
Phone (510) 992-4114

3151 Crow Canyon Pl
San Ramon, CA 94583
Phone (925) 202-0340

4505 Precissi Ln
Ste A
Stockton, CA 95207
Phone (209) 425-3815

717 E El Camino Real
Ste 5
Sunnyvale, CA 94087
Phone (408) 228-3700

2350 W Whitendale Ave
Visalia, CA 93277
Phone (559) 625-5286

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.

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": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1083259899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CORTONA WAY",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945137124",
            "telephone_number": "925-926-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CORTONA WAY STE 160",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945137157",
            "telephone_number": "925-926-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHU",
        "first_name": "GAGANJIT",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013758",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "CA",
            "license": "828947",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, CA

Sources for this page

Verify at the official NPI Registry.