Individual provider Active NPI

Simranjit Kaur Jawandha, DO

  • Family Medicine Physician
  • Rego Park, NY
National Provider Identifier
1396241584
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
309331 Issued in NY
Practice address
9777 Queens Blvd
Rego Park, NY 11374-3335
Phone
(718) 267-2420
NPI assigned
Apr 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 309331 NY Primary

Addresses

Primary practice location

9777 Queens Blvd
Rego Park, NY 11374-3335

Mailing address

9777 Queens Blvd
Rego Park, NY 11374-3335
Phone (718) 267-2420

Other practice location 1

101 Saint Andrews Ln
Glen Cove, NY 11542-2254
Phone (516) 674-7300

Other practice location 2

888 Old Country Rd
Plainview, NY 11803-4914
Phone (516) 719-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220120000097 NY Practitioner - Family PracticePractitioner - Hospitalist 9032453030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
New York College of Osteo Medicine of New York Institute of Technology, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

9777 Queens Blvd
FL 9
Rego Park, NY 11374-3335
Phone (718) 267-2420

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Oct 15, 2021 Accepting new patients
North Shore-Lij Medical PC Family Medicine CurrentSince Oct 15, 2021 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

888 Old Country Rd
Plainview, NY 11803
Phone (516) 719-2543

300 Community Dr
Plandome, NY 11030

9777 Queens Blvd
Fl 9
Rego Park, NY 11374
Phone (212) 695-5122

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1396241584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9777 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743335",
            "telephone_number": "718-267-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743335",
            "telephone_number": "718-267-2420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Saint Andrews Ln",
            "address_purpose": "LOCATION",
            "city": "Glen Cove",
            "state": "NY",
            "postal_code": "115422254",
            "country_code": "US",
            "telephone_number": "516-674-7300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "888 Old Country Rd",
            "address_purpose": "LOCATION",
            "city": "Plainview",
            "state": "NY",
            "postal_code": "118034914",
            "country_code": "US",
            "telephone_number": "516-719-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAWANDHA",
        "first_name": "SIMRANJIT",
        "middle_name": "KAUR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "309331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.