Individual provider Active NPI

Ajay Singh Bainiwal

  • Emergency Medicine Physician
  • Modesto, CA
National Provider Identifier
1407591522
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A198192 Issued in CA
Practice address
4601 Dale Rd
Modesto, CA 95356-9718
Phone
(209) 735-5000
NPI assigned
May 3, 2022
Last updated
Jul 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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
Emergency Medicine Physician 207P00000X A198192 CA Primary

Addresses

Primary practice location

4601 Dale Rd
Modesto, CA 95356-9718

Mailing address

5080 Moorcroft Cir
Stockton, CA 95206-6155

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
I20250117000484 CA Practitioner - Emergency Medicine 7719415892 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

400 W Mineral King Ave
Visalia, CA 93291-6237
Phone (559) 624-2000

4601 Dale Rd
Modesto, CA 95356-9718
Phone (209) 735-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A198192CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Permanente Medical Group Inc Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
Permanente Medical Group, Inc CurrentSince Nov 1, 2024 Accepting new patients
Permanente Medical Group Inc Emergency Medicine CurrentSince Nov 1, 2024 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

4601 Dale Rd
Modesto, CA 95356
Phone (209) 557-1000

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

5820 Owens Dr
Bldg E
Pleasanton, CA 94588
Phone (925) 737-3785

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1407591522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 MOORCROFT CIR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952066155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 DALE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569718",
            "telephone_number": "209-735-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAINIWAL",
        "first_name": "AJAY",
        "middle_name": "SINGH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-03",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A198192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.