Individual provider Active NPI

Gurdaver Singh Dhaliwal, M.D.

  • Family Medicine Physician
  • Clovis, CA
National Provider Identifier
1265620728
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A101525 Issued in CA
Practice address
1555 Shaw Ave
Ste 101
Clovis, CA 93611-4096
Phone
(559) 246-3670
NPI assigned
Oct 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A101525 CA Primary

Addresses

Primary practice location

1555 Shaw Ave
Ste 101
Clovis, CA 93611-4096

Mailing address

1555 Shaw Ave
Ste 101
Clovis, CA 93611-4096
Phone (559) 324-7001

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
I20081028000308 CA Practitioner - Family Practice 1658439120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Francisco School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1555 Shaw Ave
Suite 101
Clovis, CA 93611-4096
Phone (559) 324-7001

Hospital & facility affiliations

  • Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492

Merit-based Incentive Payment System (MIPS)

Final score
53.91 of 100Reported as individual
Quality
0
Improvement activities
40
Cost
75.1

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Apna Health Clinic Inc Past Accepting new patients
Apna Health Clinic, Inc. Past Accepting new patients

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 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": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1265620728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 SHAW AVE",
            "address_2": "STE 101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936114096",
            "telephone_number": "559-324-7001",
            "fax_number": "559-324-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SHAW AVE",
            "address_2": "STE 101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936114096",
            "telephone_number": "559-246-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHALIWAL",
        "first_name": "GURDAVER",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-10",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A101525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.