NPIMap

Organization Active NPI

Grass Valley Extended Care Inc

  • Preferred Provider Organization
  • Grass Valley, CA
National Provider Identifier
1356765218
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
Legal business name
GRASS VALLEY EXTENDED CARE INC
Practice address
280 Sierra College Dr
201
Grass Valley, CA 95945-5763
Phone
(530) 273-8452
Fax
(530) 477-5182
NPI assigned
Feb 13, 2014
Last updated
Feb 13, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
A-KULDIP GILL MD PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Authorized official

Name
Dr. Kuldip S Gill, M.D.NPI 1295882769
Title
Ceo
Phone
(530) 273-8452

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X CA Primary

Addresses

Primary practice location

280 Sierra College Dr
201
Grass Valley, CA 95945-5763

Mailing address

280 Sierra College Blvd
201
Grass Velly, CA 95945-5763
Phone (530) 273-8452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150818006193 CA Part B Supplier - Clinic/Group Practice 7416262589 Receives reassigned benefits from 9 practitioners
Practice locations: Grass Valley, CA; Citrus Heights, CA

National Provider Directory

National Provider Directory
Part of
Kuldip S Gill MD PC

Locations

7803 Madison Ave
Ste A
Citrus Heights, CA 95610

280 Sierra College Dr
Grass Valley, CA 95945
Phone (530) 273-8452

280 Sierra College Dr
#201
Grass Valley, CA 95945
Phone (530) 273-8452

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1392249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392249600000",
    "number": "1356765218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 SIERRA COLLEGE BLVD",
            "address_2": "201",
            "city": "GRASS VELLY",
            "state": "CA",
            "postal_code": "959455763",
            "telephone_number": "530-273-8452",
            "fax_number": "530-477-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 SIERRA COLLEGE DR",
            "address_2": "201",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455763",
            "telephone_number": "530-273-8452",
            "fax_number": "530-477-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRASS VALLEY EXTENDED CARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "A-KULDIP GILL MD PC",
        "enumeration_date": "2014-02-13",
        "last_updated": "2014-02-13",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "KULDIP",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "530-273-8452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.