Individual provider Active NPI

Sandeep Kaur Gill, OD

  • Optometrist
  • Sacramento, CA
National Provider Identifier
1467911347
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35545TPA Issued in CA
Practice address
8128 Delta Shores Cir S Ste 130
Sacramento, CA 95832-9108
Phone
(916) 629-8034
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011280 IL
Optometrist 152W00000X 35545TPA CA Primary

Addresses

Primary practice location

8128 Delta Shores Cir S Ste 130
Sacramento, CA 95832-9108

Mailing address

1805 Seneca Dr
Hanover Park, IL 60133-6751

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
I20240412004100 CA Practitioner - Optometry 2961841721 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35545TPACAMDOptometrist
046011280ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tedder Optometric Corporation, PC Optometrist CurrentSince Feb 28, 2025 Accepting new patients
Avani Patel Optometric Corporation Optometrist CurrentSince Mar 2, 2024 Accepting new patients
Hansra Optometric Corporation CurrentSince Feb 28, 2025 Accepting new patients
Luxottica of America Inc PastSince Oct 1, 2023 Accepting new patients

Locations

825 E Bidwell St
Ste 100
Folsom, CA 95630
Phone (279) 202-1202

4983 N Blackstone Ave
Fresno, CA 93726
Phone (510) 731-7873

23625 El Toro Rd
Ste E
Lake Forest, CA 92630
Phone (949) 227-2524

1208 Galleria Blvd
Ste 160
Roseville, CA 95678
Phone (279) 214-0170

1151 Galleria Blvd
Ste 175
Roseville, CA 95678
Phone (510) 731-7873

8128 Delta Shores Cir S
Ste 130
Sacramento, CA 95832
Phone (916) 629-8033

Organizations & group practices 4

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1467911347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 SENECA DR",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601336751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8128 DELTA SHORES CIR S STE 130",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958329108",
            "telephone_number": "916-629-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "SANDEEP",
        "middle_name": "KAUR",
        "name_prefix": "Miss",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011280",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35545TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.