Kanwaldip Kaur Bains, FNP
Individual provider Active NPI Nurse Practitioner · Fresno, CA
NPI 1316623317 · NPPES record last updated Jul 27, 2023
Key facts
- NPI
- 1316623317
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 95025154 (CA)
- Practice address
- 1510 E Herndon Ave Ste 210
Fresno, CA 93720-3333 - Phone
- (559) 450-7200
- Fax
- (559) 450-7214
- NPI assigned
- Jun 26, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Saint Agnes Medical Foundation
California Dreams Medical Corporation PC
Practice addresses (Care Compare)
1510 E Herndon Ave
Suite 110
Fresno, CA 93720-3333
Phone (559) 450-6742
3656 W Shaw Ave
Fresno, CA 93711-3231
Phone (559) 823-5252
Hospital & facility affiliations
- Saint Agnes Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.57 of 100
- Quality
- 63.43
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 77.49
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 |
|---|---|---|---|---|
| I20230823002635 | CA | Practitioner - Nurse Practitioner | 2860855848 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95025154 | CA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| California Dreams Medical Corporation PC | Current |
Accepting new patients | |
| Saint Agnes Medical Foundation | Current |
Accepting new patients | |
| LQMG Medical Group Inc. | Current | Accepting new patients | |
| Affiliated Physician Practice Inc | Past |
Accepting new patients |
Locations
1510 E Herndon Ave
Ste 110
Fresno, CA 93720
Phone (559) 450-6742
1111 E Spruce Ave
Ste 431
Fresno, CA 93720
Phone (559) 450-5611
1221 E Spruce Ave
Fresno, CA 93720
Phone (559) 449-5777
3656 W Shaw Ave
Fresno, CA 93711
Phone (559) 388-8430
1510 E Herndon Ave
Ste 210
Fresno, CA 93720
Phone (559) 450-2274
Interoperability endpoints
- kbains2716563@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95025154 | CA | Yes |
Addresses
Primary practice location
1510 E Herndon Ave Ste 210
Fresno, CA 93720-3333
Mailing address
1111 E Spruce Ave Ste 431
Fresno, CA 93720-3330
Phone (559) 450-7449
Other practice location 1
7208 W Dovewood Ln
Fresno, CA 93723-4044
Phone (559) 269-8630
Other providers in Fresno, CA
- Griffin Benjamin Bailey Jr.
- Matasha Lafaye Bailey
- Melissa Lorraine Bailey
- Bains Board and Care Inc
- Alyssa Bains
- Mandeep Bains
- Nirpaul Singh Bains
- Shashi K. Bains
- John Kenton Baird
- Jonathon David Baird
All providers in Fresno, 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 Jul 27, 2023. 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.