Individual provider Active NPI

Charanjit Kaur

  • Nurse Practitioner
  • Manteca, CA
National Provider Identifier
1285243360
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95016507 Issued in CA
Practice address
2413 Inyo Ave
Manteca, CA 95337-7818
Phone
(209) 635-9120
NPI assigned
Jul 24, 2020
Last updated
Dec 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95016507 CA Primary
Registered Nurse 163W00000X 773236 CA

Addresses

Primary practice location

2413 Inyo Ave
Manteca, CA 95337-7818

Mailing address

2413 Inyo Ave
Manteca, CA 95337-7818
Phone (209) 635-9120

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
I20220806000808 CA Practitioner - Nurse Practitioner 3274915293 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Access Physician IncGroup PAC ID 7315291473, 6 clinicians

Practice addresses (Care Compare)

1801 E March LN
Suite C310
Stockton, CA 95210-6683
Phone (209) 465-5731

4568 Feather River Dr
Suite D
Stockton, CA 95219-6508
Phone (209) 395-2360

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as group
Quality
78.83
Promoting interoperability
97
Improvement activities
40
Cost
75.53

Merit-based Incentive Payment System (MIPS)

Final score
98.95 of 100Reported as group
Quality
100
Improvement activities
40
Cost
63.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
773236CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Sleep Disorders Center a California General Partnership CurrentSince Jul 21, 2022 Accepting new patients
Access Physician Inc. CurrentSince Sep 1, 2023 Accepting new patients

Locations

1930 Tienda Dr
Ste 202
Lodi, CA 95242
Phone (209) 210-1020

1801 E March Ln
Ste C300
Stockton, CA 95210
Phone (209) 464-6422

1801 E March Ln
Ste C310
Stockton, CA 95210
Phone (209) 465-5731

4568 Feather River Dr
Ste D
Stockton, CA 95219
Phone (209) 395-2360

2453 Naglee Rd
Tracy, CA 95304
Phone (209) 395-2360

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, 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": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1285243360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 INYO AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953377818",
            "telephone_number": "209-635-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2413 INYO AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953377818",
            "telephone_number": "209-635-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "CHARANJIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-24",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95016507",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "773236",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

Verify at the official NPI Registry.