Individual provider Active NPI

Amanpreet Kaur Dulai, MD

  • Internal Medicine Physician
  • Moreno Valley, CA
National Provider Identifier
1447516919
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C172938 Issued in CA
Practice address
11441 Heacock St Ste C
Moreno Valley, CA 92557-7907
Phone
(951) 247-5809
Fax
(951) 247-5609
NPI assigned
Apr 9, 2012
Last updated
Aug 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301110948 MI
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X C172938 CA Primary

Addresses

Primary practice location

11441 Heacock St Ste C
Moreno Valley, CA 92557-7907

Mailing address

9695 S Yosemite St Ste 224
Lone Tree, CO 80124-2890

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
I20210830002950 CA Practitioner - Pediatric Medicine 0143514885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11441 Heacock St
Suite C
Moreno Valley, CA 92557-7907
Phone (951) 247-5809

7223 Church St
Suite C1
Highland, CA 92346-5869
Phone (909) 425-3946

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301110948MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 16, 2021 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Poudre Valley Medical Group, LLC PastSince Nov 12, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Children's Hospital Past Accepting new patients
University of Colorado Hospital Authority Past Accepting new patients

Locations

12021 Jacaranda Ave
Hesperia, CA 92345
Phone (909) 558-4207

7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

11441 Heacock St
Ste C
Moreno Valley, CA 92557
Phone (951) 247-5809

26780 Barton Rd
Redlands, CA 92373
Phone (909) 558-5174

Interoperability endpoints

  • Direct secure messaging: adulai414157@direct.llu.edu

Organizations & group practices 8

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 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": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1447516919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9695 S YOSEMITE ST STE 224",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801242890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11441 HEACOCK ST STE C",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577907",
            "telephone_number": "951-247-5809",
            "fax_number": "951-247-5609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULAI",
        "first_name": "AMANPREET",
        "middle_name": "KAUR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-09",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301110948",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C172938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.