Individual provider Active NPI

Gurkaran Bajwa

  • Physician Assistant
  • Fremont, CA
National Provider Identifier
1457021149
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60239 Issued in CA
Practice address
33751 Slender CT
Fremont, CA 94555-2057
Phone
(510) 579-8961
NPI assigned
Sep 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X CA
Physician Assistant 363A00000X PA60239 CA Primary

Addresses

Primary practice location

33751 Slender CT
Fremont, CA 94555-2057

Mailing address

33751 Slender CT
Fremont, CA 94555-2057

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220819001718 CA Practitioner - Physician Assistant 3476936691 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians Associates San Jose PCGroup PAC ID 8921344292, 131 clinicians

Practice addresses (Care Compare)

2105 Forest Ave
San Jose, CA 95128-1425
Phone (408) 947-2500

751 S Bascom Ave
San Jose, CA 95128-2604
Phone (408) 885-5000

Hospital & facility affiliations

  • Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
86.93
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60239CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Aug 3, 2022 Accepting new patients
County of Santa Clara CurrentSince Aug 3, 2022 Accepting new patients
County of Santa Clara CurrentSince Aug 3, 2022 Accepting new patients
Nes Western Group, a Professional Corporation CurrentSince May 20, 2023 Accepting new patients
Cep America - California CurrentSince Nov 18, 2024 Accepting new patients
County of Santa Clara CurrentSince Aug 3, 2022 Accepting new patients
Alameda Health System CurrentSince Mar 31, 2024 Accepting new patients
Alameda Health System CurrentSince Mar 31, 2024 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

170 Alameda de las Pulgas
Redwood City, CA 94062
Phone (650) 367-5536

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Interoperability endpoints

  • Direct secure messaging: gbajwa128084@alamedahs.direct-ci.com
  • Direct secure messaging: gbajwa185024@santaclaravalley.direct-ci.net

Organizations & group practices 13

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.

View all 13

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": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1457021149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33751 SLENDER CT",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945552057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33751 SLENDER CT",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945552057",
            "telephone_number": "510-579-8961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJWA",
        "first_name": "GURKARAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-15",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.