Individual provider Active NPI

Dilraj Kaur Grewal, MD

  • Family Medicine Physician
  • Stockton, CA
National Provider Identifier
1144884388
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
179935 Issued in CA
Practice address
1800 N California St
Stockton, CA 95204-6019
Phone
(209) 547-7143
Fax
(209) 547-7197
NPI assigned
Apr 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 179935 CA Primary

Addresses

Primary practice location

1800 N California St
Stockton, CA 95204-6019

Mailing address

1800 N California St
Stockton, CA 95204-6019
Phone (209) 547-7143

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
I20220805002854 CA Practitioner - Family Practice 2567844665 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 454-6868

2800 L St
Sacramento, CA 95816-5616

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
179935CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Family Medicine CurrentSince Feb 26, 2024 Accepting new patients
Sutter Valley Medical Foundation Family Medicine Current Accepting new patients
Inpatient Specialists of California, PC Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Feb 26, 2024 Accepting new patients

Locations

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

Interoperability endpoints

  • Direct secure messaging: dgrewal584570@hisp.ehr.sutterhealth.org
  • Direct secure messaging: dilraj.grewal.p1@direct.cmcentersinc.nextgenshare.com

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 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": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1144884388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019",
            "telephone_number": "209-547-7143",
            "fax_number": "209-547-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019",
            "telephone_number": "209-547-7143",
            "fax_number": "209-547-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "DILRAJ",
        "middle_name": "KAUR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "179935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.