Individual provider Active NPI

Amandeep Kaur Johal, MD

  • Family Medicine Physician
  • Sacramento, CA
National Provider Identifier
1578720462
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A115466 Issued in CA
Practice address
2693 Florin Rd
Sacramento, CA 95822-4524
Phone
(248) 635-0841
NPI assigned
May 19, 2008
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A115466 CA Primary
General Practice Physician 208D00000X A115466 CA

Addresses

Primary practice location

2693 Florin Rd
Sacramento, CA 95822-4524

Mailing address

2693 Florin Rd
Sacramento, CA 95822-4524
Phone (248) 635-0841

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
I20240522000398 CA Practitioner - Family Practice 4082868450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2693 Florin Rd
Sacramento, CA 95822-4524
Phone (248) 635-0841

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Amandeep Kaur Johal, M.D., Inc, a Medical Corporation CurrentSince Mar 12, 2024 Accepting new patients
Dignity Health Past Accepting new patients
Corrections and Rehabilitation-Headquarters PastSince Mar 22, 2020 Accepting new patients

Locations

2693 Florin Rd
Sacramento, CA 95822
Phone (916) 424-5500

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1578720462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2693 FLORIN RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958224524",
            "telephone_number": "248-635-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2693 FLORIN RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958224524",
            "telephone_number": "248-635-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHAL",
        "first_name": "AMANDEEP",
        "middle_name": "KAUR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A115466",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A115466",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.