Individual provider Active NPI

Prabhdeep Sandhu, MD

  • Cardiovascular Disease Physician
  • Burbank, CA
National Provider Identifier
1679568901
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
C54945 Issued in CA
Practice address
191 S Buena Vista St
Ste 400
Burbank, CA 91505-4554
Phone
(818) 848-0023
Fax
(818) 848-3495
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X C54945 CA Primary
Interventional Cardiology Physician 207RI0011X C54945 CA

Addresses

Primary practice location

191 S Buena Vista St
Ste 400
Burbank, CA 91505-4554

Mailing address

191 S Buena Vista St
Ste 400
Burbank, CA 91505-4554
Phone (818) 848-0023

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
I20120815000395 CA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 1456326370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

Laguna Niguel, CA 92677

201 S Buena Vista St
Suite 100
Burbank, CA 91505-4570
Phone (818) 848-6404

21501 Avalon Blvd
Suite 100
Carson, CA 90745-2210
Phone (310) 835-6627

501 S Buena Vista St
Burbank, CA 91505-4809
Phone (818) 847-3022

Hospital & facility affiliations

  • Providence Saint Joseph Medical Ctr Hospital, Burbank, CA, CCN 050235
  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C54945CAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute Current Accepting new patients
Providence Medical Institute CurrentSince Nov 21, 2015 Accepting new patients
Providence Medical Institute CurrentSince Nov 21, 2015 Accepting new patients
Dignity Health Past Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Trustees Columbia University City Ny Center Interventional Vascular TH Interventional Cardiology Past Accepting new patients

Locations

191 S Buena Vista St
Ste 200
Burbank, CA 91505
Phone (818) 887-2671

191 S Buena Vista St
Ste 150
Burbank, CA 91505
Phone (818) 295-5920

501 S Buena Vista St
Burbank, CA 91505
Phone (818) 783-0800

191 S Buena Vista St
Ste 400
Burbank, CA 91505
Phone (818) 818-0023

201 S Buena Vista St
Ste 100
Burbank, CA 91505
Phone (818) 848-6404

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

18321 Clark St
Tarzana, CA 91356
Phone (310) 423-6744

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: prabhdeep.sandhu.p1@direct.lakeside.nextgenshare.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 10

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1679568901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST",
            "address_2": "STE 400",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054554",
            "telephone_number": "818-848-0023",
            "fax_number": "818-848-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST",
            "address_2": "STE 400",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054554",
            "telephone_number": "818-848-0023",
            "fax_number": "818-848-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHU",
        "first_name": "PRABHDEEP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "C54945",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "C54945",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.