Sukhjit Kaur Sandhu – Nurse Practitioner

Key facts

NPI: 1629628763
Entity type: Individual (NPI type 1)
Primary specialty: Nurse Practitioner 363L00000X
License: 95012835 (CA)
Practice address: 801 17TH St
Modesto, CA 95354-1243
Phone: (209) 623-5469
NPI assigned: Sep 19, 2019
Sex: Female
Sole proprietor: Yes

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.

Abidali Professional Medical Inc Urgent Care Clinic/Center · Modesto, CA · NPI 1962224824

Medicare reassignment Care Compare group NPD CA
Clinic Services of California Medical Group Inc Emergency Medicine Physician · Lodi, CA · NPI 1578958450

Medicare reassignment Care Compare group NPD CA · NURSE PRACTITIONER
Team Physicians of California Medical Group Inc Emergency Medicine Physician · Delano, CA · NPI 1447288345

Medicare reassignment NPD CA · NURSE PRACTITIONER
Instant Urgent Care Urgent Care Clinic/Center · San Jose, CA · NPI 1922485085

NPD (past)

Hospital & facility affiliations 1

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

Lodi Memorial Hospital Association Inc General Acute Care Hospital · Lodi, CA · NPI 1316938301

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2019
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Clinic Services of California Medical Group Inc (65 clinicians)
Abidali Professional Medical Inc (6 clinicians)

Practice addresses (Care Compare)

1235 W Vine St
Suite 20
Lodi, CA 95240-5144
Phone (209) 334-3411

2001 McHenry Ave
Suite L
Modesto, CA 95350-3253
Phone (209) 846-3442

Hospital & facility affiliations

Adventist Health Lodi Memorial Hospital · Lodi, CA · CCN 050336

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20220810002981	CA	Practitioner - Nurse Practitioner	6709269665	Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Clinic Services of California Medical Group Inc	Nurse Practitioner	Current since Jul 7, 2022	Accepting new patients
Team Physicians of California Medical Group Inc	Nurse Practitioner	Current since Jul 7, 2022	Accepting new patients
Abidali Professional Medical Inc		Current since Oct 15, 2025	Accepting new patients
Instant Urgent Care		Past since Oct 15, 2025	Accepting new patients

Locations

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1235 W Vine St
Ste 20
Lodi, CA 95240
Phone (209) 339-7600

2001 McHenry Ave
Ste L
Modesto, CA 95350
Phone (209) 846-3442

Interoperability endpoints

Direct secure messaging: sukhjit.sandhu.p1@direct.caremorewest.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Nurse Practitioner	363L00000X	95012835	CA	Yes

Addresses

Primary practice location

801 17TH St
Modesto, CA 95354-1243

Mailing address

12900 Park Plaza Dr Ste 150
Cerritos, CA 90703-9329
Phone (562) 677-2409

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 20, 2020.

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1629628763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 PARK PLAZA DR STE 150",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907039329",
            "telephone_number": "562-677-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 17TH ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953541243",
            "telephone_number": "209-623-5469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHU",
        "first_name": "SUKHJIT",
        "middle_name": "KAUR",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-19",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95012835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

All providers in Modesto, CA · Nurse Practitioner in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.