Individual provider Active NPI

Mandeep Kaur, M.D.

  • Family Medicine Physician
  • Mendota, CA
National Provider Identifier
1376956235
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A145884 Issued in CA
Practice address
121 Barboza St
Mendota, CA 93640-1901
Phone
(559) 655-5000
Fax
(559) 655-6818
NPI assigned
Jun 9, 2014
Last updated
Jan 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X A145884 CA Primary

Addresses

Primary practice location

121 Barboza St
Mendota, CA 93640-1901

Mailing address

2505 E Divisadero St
Fresno, CA 93721-1401
Phone (559) 457-5560

Other practice location 1

2505 E Divisadero St
Fresno, CA 93721-1401
Phone (559) 457-5560

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170915001848 CA Order and Referring Only - Family PracticePractitioner - Family Practice 1658645577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
145884CAMDMarriage & Family Therapist
A145884CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fresno Community Hospital and Medical Center Past Accepting new patients
United Health Centers of the San Joaquin Valley Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mandeep.kaur.1@17661.direct.athenahealth.com

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": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1376956235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211401",
            "telephone_number": "559-457-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BARBOZA ST",
            "city": "MENDOTA",
            "state": "CA",
            "postal_code": "936401901",
            "telephone_number": "559-655-5000",
            "fax_number": "559-655-6818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2505 E Divisadero St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937211401",
            "country_code": "US",
            "telephone_number": "559-457-5560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUR",
        "first_name": "MANDEEP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A145884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendota, CA

Sources for this page

Verify at the official NPI Registry.