Individual provider Active NPI

Sandeep Kaur, PA

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1366869265
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017472 Issued in NY
Practice address
1160 Chili Ave
Rochester, NY 14624-3035
Phone
(585) 500-4814
NPI assigned
Mar 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 017472 NY Primary

Addresses

Primary practice location

1160 Chili Ave
Rochester, NY 14624-3035

Mailing address

PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700

Other names 1

  • Sandeep Kaur Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170811002680 MA Practitioner - Physician Assistant 1052474475 Reassigns benefits to 1 organization
I20180122001083 CA Practitioner - Physician Assistant 1052474475 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
017472NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare Network Current Accepting new patients
Mass General Brigham Urgent Care LLC CurrentSince May 20, 2017 Accepting new patients
Family Healthcare Network CurrentSince Jan 23, 2018 Accepting new patients
Mass General Brigham Urgent Care LLC CurrentSince May 20, 2017 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network CurrentSince Jan 23, 2018 Accepting new patients
Family Healthcare Network Current Accepting new patients

Locations

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

201 E Lakeview Ave
Woodlake, CA 93286
Phone (559) 564-0100

1285 Beacon St
Brookline, MA 02446
Phone (617) 751-6205

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCECCA

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1366869265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 CHILI AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146243035",
            "telephone_number": "585-500-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "SANDEEP",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-28",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDEEP",
            "last_name": "KAUR",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.