Individual provider Active NPI

Kanwaljit K Sidhu, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Palm Harbor, FL
National Provider Identifier
1134475627
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN9438337 Issued in FL
Practice address
2595 Tampa Rd Ste C
Palm Harbor, FL 34684-3130
Phone
(630) 849-8756
Fax
(727) 382-1382
NPI assigned
Aug 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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 APRN9438337 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN9438337 FL Primary

Addresses

Primary practice location

2595 Tampa Rd Ste C
Palm Harbor, FL 34684-3130

Mailing address

2595 Tampa Rd Ste C
Palm Harbor, FL 34684-3130
Phone (630) 849-8756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161101001591 FL Practitioner - Nurse Practitioner 2769631795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2595 Tampa Rd
Suite C
Palm Harbor, FL 34684-3130
Phone (630) 849-8756

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sidhu Health Inc Family CurrentSince Nov 15, 2023 Accepting new patients

Locations

2595 Tampa Rd
Ste C
Palm Harbor, FL 34684
Phone (630) 849-8756

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1134475627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 TAMPA RD STE C",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843130",
            "telephone_number": "630-849-8756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 TAMPA RD STE C",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843130",
            "telephone_number": "630-849-8756",
            "fax_number": "727-382-1382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "KANWALJIT",
        "middle_name": "K",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-02",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9438337",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9438337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.