Individual provider Active NPI

Surinder Singh Kohal, M.D.

  • Family Medicine Physician
  • Brentwood, CA
National Provider Identifier
1699766915
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C50698 Issued in CA
Practice address
2400 Balfour Rd
Suite 120
Brentwood, CA 94513-4945
Phone
(925) 308-8112
Fax
(925) 308-8710
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C50698 CA
Family Medicine Physician 207Q00000X C50698 CA Primary

Addresses

Primary practice location

2400 Balfour Rd
Suite 120
Brentwood, CA 94513-4945

Mailing address

Dept 34929
P.O. 39000
San Francisco, CA 94139-0001
Phone (925) 952-2828

Other identifiers 2

IdentifierTypeStateIssuer
00C506980MedicaidCA
00C506880OtherCABLUE SHIELD

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
I20050301000922 CA Practitioner - Family PracticePractitioner - Emergency Medicine 5991758914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 1976
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)

2400 Balfour Rd
Suite 120
Brentwood, CA 94513-4956
Phone (925) 308-8112

Hospital & facility affiliations

  • John Muir Home Health Services Home health agency, Concord, CA, CCN 057276
  • JMJ Home Health Services Home health agency, Brentwood, CA, CCN 059309
  • John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180
  • John Muir Medical Center - Concord Campus Hospital, Concord, CA, CCN 050496

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50698CAMDGeneral Practice Dentistry
C50698CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Physician Network CurrentSince Jun 1, 2002 Accepting new patients
Pleasanton Emergency Medical Group Emergency Medicine CurrentSince Nov 11, 2004 Accepting new patients
John Muir Health Past Accepting new patients
John Muir Health Past Accepting new patients

Locations

2400 Balfour Rd
Ste 201
Brentwood, CA 94513
Phone (925) 308-8112

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

4000 Dublin Blvd
Ste 150
Dublin, CA 94568
Phone (813) 732-7842

1133 E Stanley Blvd
Ste 151
Livermore, CA 94550

1111 E Stanley Blvd
Livermore, CA 94550
Phone (925) 373-4018

1133 E Stanley Blvd
Livermore, CA 94550
Phone (925) 373-4500

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

5555 W Las Positas Blvd
Pleasanton, CA 94588
Phone (925) 416-3418

180 Via Verde
Ste 100
San Dimas, CA 91773

Interoperability endpoints

  • Direct secure messaging: skohal8225@ehr.johnmuirhealth.com

Organizations & group practices 4

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 4

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1699766915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 34929",
            "address_2": "P.O. 39000",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941390001",
            "telephone_number": "925-952-2828",
            "fax_number": "925-952-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 BALFOUR RD",
            "address_2": "SUITE 120",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945134945",
            "telephone_number": "925-308-8112",
            "fax_number": "925-308-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHAL",
        "first_name": "SURINDER",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C50698",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C50698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C506980",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00C506880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, CA

Sources for this page

Verify at the official NPI Registry.