Individual provider Active NPI

Simran Kaur Bains

  • Internal Medicine Physician
  • Modesto, CA
National Provider Identifier
1154852994
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A169440 Issued in CA
Practice address
600 Coffee Rd
Modesto, CA 95355-4201
Phone
(209) 569-7408
NPI assigned
Mar 23, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A169440 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

600 Coffee Rd
Modesto, CA 95355-4201

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

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
I20200908001338 CA Practitioner - Internal Medicine 6204109663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
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)

1011 Sylvan Ave
Suite C
Modesto, CA 95350-1693
Phone (209) 550-4780

1700 Coffee Rd
Modesto, CA 95355-2803
Phone (209) 526-4500

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
A169440CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Sep 8, 2020 Accepting new patients
Sutter Valley Medical Foundation Internal Medicine Current Accepting new patients
Sutter Valley Medical Foundation Internal Medicine CurrentSince Sep 8, 2020 Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: sbains552456@hisp.ehr.sutterhealth.org

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.

Hospital & facility affiliations 3

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1154852994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-569-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAINS",
        "first_name": "SIMRAN",
        "middle_name": "KAUR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A169440",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.