Individual provider Active NPI

Mandeep Singh Ghuman, MD

  • Family Medicine Physician
  • Northridge, CA
National Provider Identifier
1306058151
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A108800 Issued in CA
Practice address
18460 Roscoe Blvd FL 2
Northridge, CA 91325-4107
Phone
(818) 885-5480
Fax
(818) 993-1917
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X A108800 CA
Family Medicine Physician 207Q00000X A108800 CA Primary

Addresses

Primary practice location

18460 Roscoe Blvd FL 2
Northridge, CA 91325-4107

Mailing address

3400 Data Dr
Attn Credentialing/Payer Enrollment
Rancho Cordova, CA 95670-7956

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
I20110131000846 CA Practitioner - Family PracticePractitioner - Sports Medicine 0547449969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
University of Cincinnati College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

18460 Roscoe Blvd
FL 2
Northridge, CA 91325-4107
Phone (818) 885-5480

Hospital & facility affiliations

  • Northridge Hospital Medical Center Hospital, Northridge, CA, CCN 050116

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Mar 1, 2016 Accepting new patients
Dignity Health Medical Foundation CurrentSince Mar 1, 2016 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Community Care Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

18460 Roscoe Blvd
Fl 2
Northridge, CA 91325
Phone (818) 885-5480

18406 Roscoe Blvd
Northridge, CA 91325
Phone (818) 885-5480

18460 Roscoe Blvd
Ste 100
Northridge, CA 91325
Phone (818) 717-3110

18460 Roscoe Blvd
Fl 3
Northridge, CA 91325
Phone (818) 885-5480

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1306058151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "ATTN CREDENTIALING/PAYER ENROLLMENT",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18460 ROSCOE BLVD FL 2",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254107",
            "telephone_number": "818-885-5480",
            "fax_number": "818-993-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHUMAN",
        "first_name": "MANDEEP",
        "middle_name": "SINGH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "A108800",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A108800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.