Individual provider Active NPI

Simrandeep Sandhu, PT

  • Physical Therapist
  • Stockton, CA
National Provider Identifier
1639943186
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT305210 Issued in CA
Practice address
4343 Pacific Ave Ste B1
Stockton, CA 95207-7664
Phone
(209) 425-4071
Fax
(209) 451-5687
NPI assigned
Nov 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT305210 CA Primary

Addresses

Primary practice location

4343 Pacific Ave Ste B1
Stockton, CA 95207-7664

Mailing address

408 Higuera St Ste 200
San Luis Obispo, CA 93401-6135
Phone (805) 788-0805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240104002462 CA Practitioner - Physical Therapist in Private Practice 5294186185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MDRS Spine and Sport IncGroup PAC ID 3274446687, 181 clinicians

Practice addresses (Care Compare)

7281 Lone Pine Dr
Suite D103
Rancho Murieta, CA 95683-9715
Phone (916) 364-0719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT305210CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
CV Physical Therapy, Inc Physical Therapist CurrentSince Nov 19, 2023 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Sep 2, 2025 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Sep 2, 2025 Accepting new patients

Locations

450 Rosewood Ave
Ste 105
Camarillo, CA 93010
Phone (805) 389-4781

1020 Tierra del Rey
Ste A1
Chula Vista, CA 91910
Phone (619) 585-7104

14150 Culver Dr
Ste 103
Irvine, CA 92604
Phone (949) 262-9142

7281 Lone Pine Dr
Ste D103
Rancho Murieta, CA 95683
Phone (916) 354-0719

9852 Business Park Dr
Ste A
Sacramento, CA 95827
Phone (916) 362-7962

1801 Cleveland Ave
Ste B
Santa Rosa, CA 95401
Phone (707) 526-4180

408 Higuera St
Ste 200
Sn Luis Obisp, CA 93401

4343 Pacific Ave
Ste B1
Stockton, CA 95207
Phone (209) 425-4071

5850 Canoga Ave
Ste 120
Woodland Hills, CA 91367
Phone (747) 255-4089

Interoperability endpoints

  • Direct secure messaging: ssandhu84240@sih.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1639943186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HIGUERA ST STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016135",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 PACIFIC AVE STE B1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952077664",
            "telephone_number": "209-425-4071",
            "fax_number": "209-451-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHU",
        "first_name": "SIMRANDEEP",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-14",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT305210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.