Individual provider Active NPI

Sukhvinder Kaur, FNP

  • Family Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1376284265
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95018288 Issued in CA
Practice address
1524 McHenry Ave Ste 445
Modesto, CA 95350-4573
Phone
(209) 571-1693
Fax
(209) 571-0326
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95018288 CA Primary

Addresses

Primary practice location

1524 McHenry Ave Ste 445
Modesto, CA 95350-4573

Mailing address

1769 Shellstone Way
Ripon, CA 95366-9654
Phone (209) 814-6634

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://boomeranghc.com/locations/modesto/ Health Information Exchange (HIE)

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
I20240610003873 CA Practitioner - Nurse Practitioner 1052853678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Pain Management Medical Group IncGroup PAC ID 0547252918, 42 clinicians

Practice addresses (Care Compare)

1524 McHenry Ave
Suite 445
Modesto, CA 95350-4573
Phone (209) 571-1693

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95018288CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Pain Management Medical Group, Inc. CurrentSince Apr 30, 2024 Accepting new patients

Locations

1524 McHenry Ave
Ste 445
Modesto, CA 95350
Phone (209) 571-0288

Organizations & group practices 1

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1376284265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1769 SHELLSTONE WAY",
            "city": "RIPON",
            "state": "CA",
            "postal_code": "953669654",
            "telephone_number": "209-814-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE STE 445",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504573",
            "telephone_number": "209-571-1693",
            "fax_number": "209-571-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "SUKHVINDER",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95018288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://boomeranghc.com/locations/modesto/",
            "affiliation": "N",
            "endpointDescription": "https://boomeranghc.com/locations/modesto/",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1524 McHenry Ave Ste 445",
            "city": "Modesto",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953504573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.