Individual provider Active NPI

Palwinder Kaur

  • Optometrist
  • Fresno, CA
National Provider Identifier
1447612403
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD33649TLG Issued in CA
Practice address
7600 N Blackstone Ave
Fresno, CA 93720-4300
Phone
(206) 218-7642
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OD33649TLG CA Primary

Addresses

Primary practice location

7600 N Blackstone Ave
Fresno, CA 93720-4300

Mailing address

22674 129TH PL SE
Kent, WA 98031-3978

Other practice location 1

2043 College Way
Forest Grove, OR 97116-1756
Phone (206) 218-7642

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190516000563 CA Practitioner - Optometry 9931442811 Receives reassigned benefits from 1 practitioner
Practice locations: Fresno, CA; Tracy, CA; Stockton, CA; Pittsburg, CA; Clovis, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3223 E Hammer LN
Stockton, CA 95212-2815
Phone (209) 244-4816

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD33649TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Palwinder Kaur Optometrist CurrentSince Mar 26, 2024 Accepting new patients

Locations

323 W Shaw Ave
Clovis, CA 93612
Phone (559) 297-4391

7600 N Blackstone Ave
Fresno, CA 93720
Phone (206) 218-7642

7065 N Ingram Ave
Fresno, CA 93650
Phone (559) 371-1696

4080 W Shaw Ave
Fresno, CA 93722
Phone (206) 218-7642

2203 Loveridge Rd
Pittsburg, CA 94565
Phone (925) 252-1829

3223 E Hammer Ln
Stockton, CA 95212
Phone (209) 244-4816

3010 W Grant Line Rd
Tracy, CA 95304
Phone (209) 792-4899

Practitioners & affiliated clinicians

Practitioners 1

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1447612403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22674 129TH PL SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980313978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 N BLACKSTONE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937204300",
            "telephone_number": "206-218-7642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2043 College Way",
            "address_purpose": "LOCATION",
            "city": "Forest Grove",
            "state": "OR",
            "postal_code": "971161756",
            "country_code": "US",
            "telephone_number": "206-218-7642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUR",
        "first_name": "PALWINDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OD33649TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.