Individual provider Active NPI

Sukhdev Dhindsa, MD

  • Emergency Medicine Physician
  • Kokomo, IN
National Provider Identifier
1174533301
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01040744 Issued in IN
Practice address
1907 W Sycamore St
Kokomo, IN 46901-5148
Phone
(317) 870-0490
Fax
(317) 870-0499
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01040744 IN Primary

Addresses

Primary practice location

1907 W Sycamore St
Kokomo, IN 46901-5148

Mailing address

PO Box 6069
Dept. #32
Indianapolis, IN 46206-6069
Phone (317) 870-0490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100722000424 IN Practitioner - Emergency Medicine 3971635277 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01040744INMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Apr 15, 2014 Accepting new patients
Mesa Indiana Ed Associates, LLC Emergency Medicine Past Accepting new patients

Locations

1907 W Sycamore St
Kokomo, IN 46901
Phone (765) 452-5611

1451 N Gardner St
Scottsburg, IN 47170
Phone (812) 752-8500

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1174533301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "address_2": "DEPT. #32",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462066069",
            "telephone_number": "317-870-0490",
            "fax_number": "317-870-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 W SYCAMORE ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469015148",
            "telephone_number": "317-870-0490",
            "fax_number": "317-870-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHINDSA",
        "first_name": "SUKHDEV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01040744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.