Individual provider Active NPI

Ravindar Kaur, FNP

  • Family Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1134570864
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95004158 Issued in CA
Practice address
1717 Las Vegas St
Modesto, CA 95358-5500
Phone
(209) 576-4200
NPI assigned
Jun 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95004158 CA Primary

Addresses

Primary practice location

1717 Las Vegas St
Modesto, CA 95358-5500

Mailing address

1910 Customer Care Way
Atwater, CA 95301-5167
Phone (209) 384-6488

Other practice location 1

7471 N Fresno St
Fresno, CA 93720-2457
Phone (559) 436-4500

Other practice location 2

7471 N Fresno St
Fresno, CA 93720-2457
Phone (559) 436-4500

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
I20160901002177 CA Practitioner - Nurse Practitioner 9830485796 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sinu-Clear IncGroup PAC ID 6507950367, 5 clinicians

Practice addresses (Care Compare)

Community Extended Care
9620 Fremont Ave
Montclair, CA 91763-2320
Phone (909) 621-4751

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sinu-Clear Inc CurrentSince Mar 13, 2025 Accepting new patients
The Noble Group a Medical Corporation CurrentSince Aug 1, 2020 Accepting new patients
Dignity Health PastSince Aug 1, 2020 Accepting new patients

Locations

394 E Yosemite Ave
Merced, CA 95340
Phone (209) 383-3990

3144 G St
Ste 125
Merced, CA 95340
Phone (209) 383-3990

9620 Fremont Ave
Montclair, CA 91763
Phone (909) 227-0750

1550 N Park Ave
Pomona, CA 91768
Phone (909) 623-0791

Organizations & group practices 3

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": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1134570864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 CUSTOMER CARE WAY",
            "city": "ATWATER",
            "state": "CA",
            "postal_code": "953015167",
            "telephone_number": "209-384-6488",
            "fax_number": "855-202-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 LAS VEGAS ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953585500",
            "telephone_number": "209-576-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7471 N Fresno St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937202457",
            "country_code": "US",
            "telephone_number": "559-436-4500",
            "fax_number": "559-436-0500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7471 N Fresno St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937202457",
            "country_code": "US",
            "telephone_number": "559-436-4500",
            "fax_number": "559-436-0500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUR",
        "first_name": "RAVINDAR",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95004158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.