NPIMap

Individual provider Active NPI

Paula R Dhanda

  • Gynecology Physician
  • Kelseyville, CA
National Provider Identifier
1316972425
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
G62526 Issued in CA
Practice address
5685 Main Street
Kelseyville, CA 95451
Phone
(707) 263-8733
Fax
(707) 262-0313
NPI assigned
Jul 11, 2006
Last updated
Aug 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X G62526 CA Primary

Addresses

Primary practice location

5685 Main Street
Kelseyville, CA 95451

Mailing address

5685 Main St
Kelseyville, CA 95451-8945
Phone (707) 263-8733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061218000486 CA Practitioner - Obstetrics/Gynecology 4284633314 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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

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

Merit-based Incentive Payment System (MIPS)

Final score
90.74 of 100Reported as group
Quality
94
Promoting interoperability
92
Improvement activities
40
Cost
65.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G62526CAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Care and Surgery Center Gynecology CurrentSince May 13, 2015 Accepting new patients
Adventist Health Clearlake Hospital Inc. CurrentSince Aug 23, 2023 Accepting new patients
Specialty Care and Surgery Center CurrentSince May 20, 2007 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Specialty Care and Surgery Center Gynecology Past Accepting new patients
Adventist Health Clearlake Hospital, Inc Past Accepting new patients

Locations

15230 Lakeshore Dr
Clearlake, CA 95422
Phone (707) 995-4500

15322 Lakeshore Dr
Ste 202
Clearlake, CA 95422
Phone (707) 994-0303

15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820

5685 Main St
Kelseyville, CA 95451
Phone (707) 279-8733

Interoperability endpoints

  • Direct secure messaging: pdhanda194555@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1316972425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5685 MAIN ST",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954518945",
            "telephone_number": "707-263-8733",
            "fax_number": "707-279-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5685 MAIN STREET",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "95451",
            "telephone_number": "707-263-8733",
            "fax_number": "707-262-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHANDA",
        "first_name": "PAULA",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "G62526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kelseyville, CA

Sources for this page

Verify at the official NPI Registry.