Paula R Dhanda
Individual provider Active NPI Gynecology Physician · Kelseyville, CA
NPI 1316972425 · NPPES record last updated Aug 13, 2015
Key facts
- NPI
- 1316972425
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gynecology Physician 207VG0400X
- License
- G62526 (CA)
- Practice address
- 5685 Main Street
Kelseyville, CA 95451 - Phone
- (707) 263-8733
- Fax
- (707) 262-0313
- NPI assigned
- Jul 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 16
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- State University of New York at Stony Brook, School of Medicine, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Adventist Health Clearlake Hospital Inc.
Practice addresses (Care Compare)
15630 18TH Ave
Clearlake, CA 95422-9336
Phone (707) 994-6486
5685 Main St
Kelseyville, CA 95451-8945
Phone (707) 279-8733
Hospital & facility affiliations
- Sutter Lakeside Hospital
- Adventist Health Clearlake
- Adventist Health Ukiah Valley
- Adventist Health St Helena
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.74 of 100
- Quality
- 94
- Promoting interoperability
- 92
- Improvement activities
- 40
- Cost
- 65.12
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: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061218000486 | CA | Practitioner - Obstetrics/Gynecology | 4284633314 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G62526 | CA | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Specialty Care and Surgery Center | Gynecology | Current |
Accepting new patients |
| Adventist Health Clearlake Hospital Inc. | Current |
Accepting new patients | |
| Specialty Care and Surgery Center | Current |
Accepting new patients | |
| Sutter Bay Hospitals | Past | Accepting new patients | |
| Adventist Health Clearlake Hospital, Inc | Past | Accepting new patients | |
| Specialty Care and Surgery Center | Gynecology | Past | Accepting new patients |
Locations
15322 Lakeshore Dr
Ste 202
Clearlake, CA 95422
Phone (707) 994-0303
15230 Lakeshore Dr
Clearlake, CA 95422
Phone (707) 995-4500
15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820
5685 Main St
Kelseyville, CA 95451
Phone (707) 279-8733
Interoperability endpoints
- pdhanda194555@hisp.ehr.sutterhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | G62526 | CA | Yes |
Addresses
Primary practice location
5685 Main Street
Kelseyville, CA 95451
Mailing address
5685 Main St
Kelseyville, CA 95451-8945
Phone (707) 263-8733
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0061470 | Medicaid | CA |
Other providers in Kelseyville, CA
- Gloria Campbell
- Ruby C Carlson Larson
- Carol a. Richards PSYD.
- Jennifer Chwialkowski
- Timari Cole
- Christina Marie Drukala
- Paul Seymour Farley
- Growell
- James Prasert Iamsurey
- Prasong Iamsurey
All providers in Kelseyville, CA · Gynecology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2015. 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.