Sierra Care at the Lake,LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SIERRA CARE AT THE LAKE,LLC

Practice address

648 W Sierra Ave
Clovis, CA 93612-0151

Phone

(559) 325-6100

Fax

(559) 553-8840

NPI assigned

Sep 13, 2019

Organization subpart

No

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

Authorized official

Name

Gary Andrew Ponticiello

Title

President

Phone

(559) 539-2727

Specialties & licenses 4

Addresses

Other names 1

• Sierra Care Clovis Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Sierra Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Sierra Care at the Lake,LLC

  • Skilled Nursing Facility
  • Springville, CA
  • NPI 1235789462
  NPD tax ID
• Sierra Care at the Lake,LLC

  • Skilled Nursing Facility
  • Springville, CA
  • NPI 1508265414
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568332800000",
    "number": "1336799170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 W SIERRA AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120151",
            "telephone_number": "559-325-6100",
            "fax_number": "559-553-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 W SIERRA AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120151",
            "telephone_number": "559-325-6100",
            "fax_number": "559-553-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA CARE AT THE LAKE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-13",
        "last_updated": "2019-09-13",
        "status": "A",
        "authorized_official_last_name": "PONTICIELLO",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-539-2727"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sierra Care Clovis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gina M Sian, OT
• Maria Socorro Sicairos
• Katelyn Sidamrong
• Arvinderpal Kaur Sidhu
• Pritpal Kaur Sidhu, FNP
• Sierra Functional Medical PC
• Sierra Heart and Vascular Institute
• Sierra Imaging Associates Medical Group Professional Corporation
• Sierra Meadows Behavioral Health
• Sierra Meadows Behavioral Health

• Skilled Nursing Facility in Clovis, CA
• Providers in Clovis, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.