Individual provider Active NPI

Ravleen Kaur Grewal, MD

  • Hematology & Oncology Physician
  • Stockton, CA
National Provider Identifier
1679078885
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A195347 Issued in CA
Practice address
2626 N California St Ste B
Stockton, CA 95204-5500
Phone
(209) 466-2626
Fax
(209) 466-7153
NPI assigned
Mar 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X A195347 CA Primary

Addresses

Primary practice location

2626 N California St Ste B
Stockton, CA 95204-5500

Mailing address

2626 N California St Ste B
Stockton, CA 95204-5500
Phone (209) 466-2626

Other practice location 1

375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 862-3229

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
I20241017004003 CA Practitioner - Hematology/OncologyPractitioner - Medical Oncology 7618226101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stockton Hematology Oncology Medical Group IncGroup PAC ID 1456369800, 9 clinicians

Practice addresses (Care Compare)

2626 N California St
Suite B
Stockton, CA 95204-5500
Phone (209) 466-2626

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A195347CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stockton Hematology Oncology Medical Group, Inc Hematology & Oncology CurrentSince Nov 1, 2024 Accepting new patients
Mark Twain Medical Center CurrentSince Sep 10, 2024 Accepting new patients

Locations

300 Northgate Dr
Manteca, CA 95336
Phone (209) 665-4782

700 Mountain Ranch Rd
Ste B
San Andreas, CA 95249
Phone (209) 754-9670

768 Mountain Ranch Rd
San Andreas, CA 95249
Phone (209) 464-6422

2626 N California St
Ste L
Stockton, CA 95204

2626 N California St
Ste B
Stockton, CA 95204
Phone (209) 466-2626

Interoperability endpoints

  • FHIR API: https://fhir.prod.flatiron.io/fhir/

Organizations & group practices 2

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 3

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": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1679078885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 N CALIFORNIA ST STE B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045500",
            "telephone_number": "209-466-2626",
            "fax_number": "209-466-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 N CALIFORNIA ST STE B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045500",
            "telephone_number": "209-466-2626",
            "fax_number": "209-466-7153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 Dixmyth Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452202475",
            "country_code": "US",
            "telephone_number": "513-862-3229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "RAVLEEN",
        "middle_name": "KAUR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A195347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.