Individual provider Active NPI

Gurjeet Mahal, PA-C

  • Physician Assistant
  • Fremont, CA
National Provider Identifier
1194759704
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16792 Issued in CA
Practice address
734 Mowry Ave
Fremont Medical Group
Fremont, CA 94536-4115
Phone
(510) 793-3033
Fax
(510) 793-4952
NPI assigned
Jul 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16792 CA Primary

Addresses

Primary practice location

734 Mowry Ave
Fremont Medical Group
Fremont, CA 94536-4115

Mailing address

734 Mowry Ave
Fremont, CA 94536-4115
Phone (510) 793-3033

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
I20080510000081 CA Practitioner - Physician Assistant 6204915606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

39500 Fremont Blvd
Suite 100
Fremont, CA 94538-2101
Phone (510) 687-9510

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.74 of 100Reported as group
Quality
66.48
Promoting interoperability
100
Improvement activities
40
Cost
75.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
16792CAMDChiropractor
PA16792CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Township Medical Foundation CurrentSince Apr 11, 2015 Accepting new patients
Washington Township Medical Group Past Accepting new patients

Locations

2500 Mowry Ave
Ste 255
Fremont, CA 94538

39500 Fremont Blvd
Ste 100
Fremont, CA 94538
Phone (510) 248-1800

734 Mowry Ave
Fremont, CA 94536
Phone (510) 742-6274

Interoperability endpoints

  • Direct secure messaging: gmahal16517@direct.whhs.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194759704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364115",
            "telephone_number": "510-793-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 MOWRY AVE",
            "address_2": "FREMONT MEDICAL GROUP",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364115",
            "telephone_number": "510-793-3033",
            "fax_number": "510-793-4952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAL",
        "first_name": "GURJEET",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.