Individual provider Active NPI

Harjinder Singh Sidhu

  • Family Medicine Physician
  • Modesto, CA
National Provider Identifier
1689317869
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8805 Issued in CA
Practice address
1400 Florida Ave Ste 102
Modesto, CA 95350-4446
Phone
(916) 865-7030
NPI assigned
Apr 15, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 8805 CA Primary

Addresses

Primary practice location

1400 Florida Ave Ste 102
Modesto, CA 95350-4446

Mailing address

232 Bald Eagle CT
Roseville, CA 95747-4918
Phone (916) 865-7030

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
I20241105003320 CA Practitioner - Family Practice 5698209237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalists of Modesto Medical Group IncGroup PAC ID 2567360027, 87 clinicians

Practice addresses (Care Compare)

1441 Florida Ave
Modesto, CA 95350-4405
Phone (209) 576-3525

Hospital & facility affiliations

  • Emanuel Medical Center Hospital, Turlock, CA, CCN 050179
  • Doctors Medical Center Hospital, Modesto, CA, CCN 050464
  • Mercy Medical Center Hospital, Merced, CA, CCN 050444
  • Oak Valley Hospital District Hospital, Oakdale, CA, CCN 050067
  • John C Fremont Healthcare District Hospital, Mariposa, CA, CCN 051304

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8805CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalists of Modesto Medical Group Inc CurrentSince Nov 1, 2024 Accepting new patients
Hospitalists of Modesto Medical Group Past Accepting new patients

Locations

1700 McHenry Ave
Ste 65B
Modesto, CA 95350
Phone (209) 581-7063

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

Interoperability endpoints

  • Direct secure messaging: harjinder.sidhu.1@32273.direct.athenahealth.com

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 5

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": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1689317869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 BALD EAGLE CT",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957474918",
            "telephone_number": "916-865-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 FLORIDA AVE STE 102",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504446",
            "telephone_number": "916-865-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "HARJINDER",
        "middle_name": "SINGH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-15",
        "last_updated": "2024-07-08",
        "certification_date": "2024-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "8805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.