Individual provider Active NPI

Balraj Singh Bajwa, PMHNP-BC, RN, CNL

  • Psychiatric/Mental Health Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1285191742
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95020092 Issued in CA
Practice address
2001 The Alameda
San Jose, CA 95126-1136
Phone
(408) 261-7777
Fax
(408) 259-2273
NPI assigned
Feb 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95172660 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95020092 CA Primary

Addresses

Primary practice location

2001 The Alameda
San Jose, CA 95126-1136

Mailing address

2001 The Alameda
San Jose, CA 95126-1136
Phone (669) 319-2621

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
I20220421001397 CA Practitioner - Nurse Practitioner 8426445438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Momentum for HealthGroup PAC ID 2769377217, 41 clinicians

Practice addresses (Care Compare)

2001 The Alameda
San Jose, CA 95126-1136
Phone (408) 938-6750

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95020092CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum for Health CurrentSince Apr 30, 2022 Accepting new patients
Momentum for Health CurrentSince Apr 30, 2022 Accepting new patients

Locations

438 N White Rd
San Jose, CA 95127
Phone (408) 254-6828

2001 The Alameda
San Jose, CA 95126
Phone (408) 938-6750

1922 The Alameda
Ste 316
San Jose, CA 95126
Phone (408) 637-0341

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.

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": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1285191742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261136",
            "telephone_number": "669-319-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261136",
            "telephone_number": "408-261-7777",
            "fax_number": "408-259-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJWA",
        "first_name": "BALRAJ",
        "middle_name": "SINGH",
        "credential": "PMHNP-BC, RN, CNL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-20",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95172660",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95020092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.