Individual provider Active NPI

Inderjit K Dhaliwal, O.D.

  • Optometrist
  • Fresno, CA
National Provider Identifier
1194845206
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
013142T Issued in CA
Practice address
3680 W Shaw Ave
Fresno, CA 93711-3231
Phone
(559) 277-1785
Fax
(559) 277-1036
NPI assigned
Mar 30, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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
Optometrist 152W00000X 013142T CA Primary

Addresses

Primary practice location

3680 W Shaw Ave
Fresno, CA 93711-3231

Mailing address

5951 N Sycamore Ave
Fresno, CA 93722-8111
Phone (559) 277-1785

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140917001037 CA Practitioner - Optometry 6608095088 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013142TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fogg Remington Eyecare Inc Current Accepting new patients
Fogg Remington Eyecare Inc Optometrist CurrentSince Feb 24, 2016 Accepting new patients
Fogg Remington Eyecare, Inc. CurrentSince Feb 24, 2016 Accepting new patients
Valley Regional Anesthesia Associates Inc Past Accepting new patients

Locations

1817 Shaw Ave
Ste 104
Clovis, CA 93611
Phone (559) 449-5010

1360 E Herndon Ave
Ste 401
Fresno, CA 93720
Phone (209) 449-5010

3830 N 1st St
Fresno, CA 93726
Phone (559) 449-5010

2401 W Cleveland Ave
Madera, CA 93637
Phone (559) 449-5010

40232 Junction Dr
Oakhurst, CA 93644
Phone (559) 449-5010

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: inderjit.dhaliwal.1@17661.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194845206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5951 N SYCAMORE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937228111",
            "telephone_number": "559-277-1785",
            "fax_number": "559-277-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 W SHAW AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113231",
            "telephone_number": "559-277-1785",
            "fax_number": "559-277-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHALIWAL",
        "first_name": "INDERJIT",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "013142T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.