Organization Active NPI

Nikita Gill, M.D., Inc.

  • Interventional Cardiology Physician
  • Redding, CA
National Provider Identifier
1396811568
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
A77028 Issued in CA
Legal business name
NIKITA GILL, M.D., INC.
Practice address
2175 Rosaline Ave
Redding, CA 96001-2549
Phone
(530) 225-6000
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Authorized official

Name
Nikita K. Gill, M.D.NPI 1255366514
Title
President
Phone
(530) 410-8007

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
Interventional Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0011X A77028 CA Primary

Addresses

Primary practice location

2175 Rosaline Ave
Redding, CA 96001-2549

Mailing address

PO Box 990208
Redding, CA 96099-0208
Phone (530) 212-0073

Other identifiers 2

IdentifierTypeStateIssuer
2930889OtherCACORPORATION NUMBER
A77028OtherCALICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070117000241 CA Part B Supplier - Clinic/Group Practice 6103827282 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Shasta, CA; Redding, CA

National Provider Directory

National Provider Directory

Locations

2626 Edith Ave
Ste C
Redding, CA 96001
Phone (530) 241-3316

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691366400000",
    "number": "1396811568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 990208",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960990208",
            "telephone_number": "530-212-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 ROSALINE AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012549",
            "telephone_number": "530-225-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIKITA GILL, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "NIKITA",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-410-8007",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A77028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATION NUMBER",
            "identifier": "2930889",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "A77028",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.