Individual provider Active NPI

Ravjeet K Kullar, M.D.

  • Family Medicine Physician
  • Walnut Creek, CA
National Provider Identifier
1669675294
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A96939 Issued in CA
Practice address
1450 Treat Blvd
Ste 320
Walnut Creek, CA 94597-2168
Phone
(925) 296-9880
Fax
(925) 296-9011
NPI assigned
Jun 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A96939 CA Primary

Addresses

Primary practice location

1450 Treat Blvd
Ste 320
Walnut Creek, CA 94597-2168

Mailing address

1450 Treat Blvd
Walnut Creek, CA 94597-2168

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
I20091219000059 CA Practitioner - Family Practice 6406996693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Davis School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
John Muir Physician NetworkGroup PAC ID 6608789813, 488 clinicians

Practice addresses (Care Compare)

1450 Treat Blvd
Suite 320
Walnut Creek, CA 94597-2168
Phone (925) 296-9880

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A96939CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Physician Network CurrentSince Jul 1, 2016 Accepting new patients
John Muir Health Past Accepting new patients
John Muir Health Past Accepting new patients

Locations

2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112

380 Civic Dr
Ste 100
Pleasant Hill, CA 94523
Phone (925) 284-3840

1450 Treat Blvd
Ste 320
Walnut Creek, CA 94597
Phone (925) 296-9827

1450 Treat Blvd
Ste 300
Walnut Creek, CA 94597

1450 Treat Blvd
Walnut Creek, CA 94597
Phone (925) 952-2828

Interoperability endpoints

  • Direct secure messaging: rkullar58142@ehr.johnmuirhealth.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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1181433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1669675294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 TREAT BLVD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 TREAT BLVD",
            "address_2": "STE 320",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972168",
            "telephone_number": "925-296-9880",
            "fax_number": "925-296-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULLAR",
        "first_name": "RAVJEET",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-10",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A96939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.