Amanpreet Dhaliwal, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

71664 Issued in WI

Practice address

200 E Ryan Rd
Oak Creek, WI 53154

Phone

(414) 570-3590

Fax

(414) 570-3599

NPI assigned

Jul 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI, NY2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: amanpreetdhaliwal@nslijmedgr.allscriptsdirect.net

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.

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Family Medicine

  Medicare reassignment Care Compare group NPD
• North Shore - Lij Medical PC

  dba NSLIJ Medical In Queens

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  Care Compare affiliation

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1548756281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E RYAN RD",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531544563",
            "telephone_number": "414-570-3590",
            "fax_number": "414-570-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E RYAN RD",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "53154",
            "telephone_number": "414-570-3590",
            "fax_number": "414-570-3599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 James St",
            "address_purpose": "LOCATION",
            "city": "Edison",
            "state": "NJ",
            "postal_code": "088203947",
            "country_code": "US",
            "telephone_number": "732-321-7487",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "65 James St",
            "address_purpose": "LOCATION",
            "city": "Edison",
            "state": "NJ",
            "postal_code": "088203947",
            "country_code": "US",
            "telephone_number": "732-321-7487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DHALIWAL",
        "first_name": "AMANPREET",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-05",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "71664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100092284",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adhaliwal236916@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 E Ryan Rd",
            "city": "Oak Creek",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "200 E Ryan Rd",
            "city": "Oak Creek",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shelly S Debo, NP
• Taylore Delong, MS, LPC-IT
• Kathryn Demiri
• Dental 360 Oak Creek LLC
• Rachel Dexl
• Digitrace Care Services Inc
• Duy-Bao Phan Dinh, M.D.
• Alexandria L Dollhopf, PT, DPT
• John Vincent Donlon III, DC
• Kelly Dorfner, PTA

• Family Medicine Physician in Oak Creek, WI
• Providers in Oak Creek, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.