Individual provider Active NPI

Gavneet Uppal, FNP-C

  • Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1154047181
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95030427 Issued in CA
Practice address
4577 La Jolla Village Dr Ste 1212
San Diego, CA 92122-1494
Phone
(619) 894-9582
NPI assigned
Oct 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28244838A IN
Registered Nurse 163W00000X 95374146 CA
Family Nurse Practitioner 363LF0000X 71013180A IN
Nurse Practitioner 363L00000X 95030427 CA Primary

Addresses

Primary practice location

4577 La Jolla Village Dr Ste 1212
San Diego, CA 92122-1494

Mailing address

1213 American Ave
Plainfield, IN 46168-3268
Phone (317) 410-1131

Other practice location 1

12760 Meeting House Rd
Carmel, IN 46032-7292
Phone (317) 721-7110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95374146CAMDRegistered Nurse
28244838AINMDRegistered Nurse
95030427CAMDNurse Practitioner
71013180AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robey Plastic Surgery CurrentSince Oct 1, 2022 Accepting new patients

Locations

12760 Meeting House Rd
Carmel, IN 46032
Phone (317) 721-7110

Organizations & group practices 1

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": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1154047181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 AMERICAN AVE",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461683268",
            "telephone_number": "317-410-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4577 LA JOLLA VILLAGE DR STE 1212",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221494",
            "telephone_number": "619-894-9582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12760 Meeting House Rd",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460327292",
            "country_code": "US",
            "telephone_number": "317-721-7110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UPPAL",
        "first_name": "GAVNEET",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28244838A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95374146",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71013180A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95030427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.