Manmeet Johal, FNP
Individual provider Active NPI Nurse Practitioner · Gustine, CA
NPI 1225371925 · NPPES record last updated Feb 11, 2022
Key facts
- NPI
- 1225371925
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 22795 (CA)
- Practice address
- 489 5TH St
Gustine, CA 95322-1514 - Phone
- (209) 854-3728
- NPI assigned
- Apr 1, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Permanente Medical Group Inc
Community Health Centers of America
Practice addresses (Care Compare)
2500 Merced St
San Leandro, CA 94577-4201
Phone (510) 454-1000
5320 Hwy 49 N
Suite 1 3
Mariposa, CA 95338-9588
Phone (209) 966-2344
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151020003010 | CA | Practitioner - Nurse Practitioner | 5496064115 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22795 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group Inc | Current |
Accepting new patients | |
| Community Health Centers of America | Current |
Accepting new patients | |
| Permanente Medical Group Inc | Current | Accepting new patients | |
| Permanente Medical Group, Inc | Current |
Accepting new patients | |
| Community Health Centers of America | Current |
Accepting new patients |
Locations
750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131
4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738
489 5th St
Gustine, CA 95322
Phone (209) 854-3728
900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014
517 Main St
#A
Livingston, CA 95334
Phone (209) 445-2388
5320 State Highway 49 N
Mariposa, CA 95338
Phone (209) 383-5200
5320 State Highway 49 N
Ste 1
Mariposa, CA 95338
Phone (209) 966-2225
5320 State Highway 49 N
Ste 13
Mariposa, CA 95338
Phone (209) 966-2344
733 3rd St
Mc Farland, CA 93250
Phone (661) 792-3097
101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
930 W Main St
Ripon, CA 95366
Phone (209) 599-4221
501 J St
Sacramento, CA 95814
Phone (916) 497-3000
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
2500 Merced St
San Leandro, CA 94577
Phone (510) 454-1000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 22795 | CA | Yes |
| Primary Care Nurse Practitioner | 363LP2300X | 22795 | CA |
Addresses
Primary practice location
489 5TH St
Gustine, CA 95322-1514
Mailing address
2662 Remington Way
Tracy, CA 95377-6695
Phone (209) 833-7440
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in Gustine, CA
- Sandra J. Haar
- Danielle I Haro
- Adriana Herrera
- Pattabiraman Balam Iyer
- James S. Linville, O.D.
- Jose a Garcia DO Medical Professional Corporation
- James S. Linville
- Rosemary Casandra Lucero
- Newman Pioneer Drug Inc
- Stacia Orr
All providers in Gustine, CA · Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.