Individual provider Active NPI

Kiranjyot Boparai, FNP-BC

  • Family Nurse Practitioner
  • South San Francisco, CA
National Provider Identifier
1326784448
Registry record updated Sep 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12665 Issued in CA
Practice address
165 Francisco Dr
South San Francisco, CA 94080-5931
Phone
(650) 636-4523
NPI assigned
May 11, 2022
Last updated
Sep 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12665 CA Primary
Registered Nurse 163W00000X 480893 CA

Addresses

Primary practice location

165 Francisco Dr
South San Francisco, CA 94080-5931

Mailing address

165 Francisco Dr
South San Francisco, CA 94080-5931
Phone (650) 636-4523

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
I20260515001198 CA Practitioner - Nurse Practitioner 3375012636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

113 Trotter St
Coalinga, CA 93210-3614

1145 Phelps Ave
Suite 104
Coalinga, CA 93210-9508

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
480893CAMDRegistered Nurse
12665CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coalinga Valley Health Clinics. Inc PastSince May 1, 2026 Accepting new patients

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": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662854400000",
    "number": "1326784448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 FRANCISCO DR",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805931",
            "telephone_number": "650-636-4523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 FRANCISCO DR",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805931",
            "telephone_number": "650-636-4523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOPARAI",
        "first_name": "KIRANJYOT",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-09-11",
        "certification_date": "2022-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "12665",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "480893",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South San Francisco, CA

Sources for this page

Verify at the official NPI Registry.