Individual provider Active NPI

Manmohan Gursahani, MD

  • Urology Physician
  • Fullerton, CA
National Provider Identifier
1720042336
Registry record updated Dec 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
C51339 Issued in CA
Practice address
1024 Ferndale Ave
Fullerton, CA 92831
Phone
(559) 241-4513
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X C51339 CA Primary

Addresses

Primary practice location

1024 Ferndale Ave
Fullerton, CA 92831

Mailing address

1211 W la Palma Ave
Ste 502
Anaheim, CA 92801-2812
Phone (714) 267-4411

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
I20121121000266 CA Practitioner - Urology 4981660883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alfred a Sidhom M D IncGroup PAC ID 9335053420, 3 clinicians

Practice addresses (Care Compare)

1211 W la Palma Ave
Suite 502
Anaheim, CA 92801-2812
Phone (714) 776-7090

Hospital & facility affiliations

  • Ahmc Anaheim Regional Medical Center Hospital, Anaheim, CA, CCN 050226

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St. Louis Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Anaheim Global Medical Center, Inc Past Accepting new patients
Mercy Hospital South Past Accepting new patients
Talbert Medical Group, P.C. Urology Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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 1

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482451200000",
    "number": "1720042336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE",
            "address_2": "STE 502",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012812",
            "telephone_number": "714-267-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 FERNDALE AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "92831",
            "telephone_number": "559-241-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURSAHANI",
        "first_name": "MANMOHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2016-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "C51339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.