Pardeep Paul Dhanoa, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

60 241190 Issued in NY

Practice address

1026 Union Rd
West Seneca, NY 14224-3445

Phone

(716) 712-0851

Fax

(716) 712-0853

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Internal Medicine

Education

New York College of Osteo Medicine of New York Institute of Technology, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Luminis Health Anne Arundel Medical Center, Inc Hospital, Annapolis, MD, CCN 210023

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Halethorpe, MD
  • NPI 1043378656
  Medicare reassignment Care Compare group NPD
• Luminis Health Medical Group, LLC

  • Maternal & Fetal Medicine Physician
  • Annapolis, MD
  • NPI 1073580205
  Medicare reassignment Care Compare group
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC, Family Medicine

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Glen Burnie, MD
  • NPI 1285752121
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Gaithersburg, MD
  • NPI 1831471713
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Luminis Health Medical Group, LLC

  • Internal Medicine Physician
  • Bowie, MD
  • NPI 1720835010
  NPD
• Luminis Health Medical Group, LLC

  • Surgery Physician
  • Annapolis, MD
  • NPI 1992197453
  NPD
• Luminis Health Medical Group, LLC

  • Internal Medicine Physician
  • Annapolis, MD
  • NPI 1477862308
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Luminis Health Anne Arundel Medical Center, Inc.

  • Clinical Medical Laboratory
  • Annapolis, MD
  • NPI 1356885032

  Hospital

  Care Compare affiliation
• Luminis Health Anne Arundel Medical Center, Inc.

  • General Acute Care Hospital
  • Annapolis, MD
  • NPI 1477517225
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624665600000",
    "number": "1730295155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 UNION RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243445",
            "telephone_number": "716-712-0851",
            "fax_number": "716-712-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 UNION RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243445",
            "telephone_number": "716-712-0851",
            "fax_number": "716-712-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHANOA",
        "first_name": "PARDEEP",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-06-26",
        "certification_date": "2021-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "60 241190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02842693",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7070 Samuel Morse Dr",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210463424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7070 Samuel Morse Dr",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210463424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter D. Derose, D.D.S.
• Lauren Marie Destro, DPT
• Tina Destro
• Colleen M Dhafir, N.P.
• Mazin A Dhafir, M.D.
• Diane M. Sanfilippo
• Diane M. Sanfilippo MD OB-GYN PC
• Felicia Diaz
• Atarah Dickinson
• Erin E Diebold, PA

• Family Medicine Physician in West Seneca, NY
• Providers in West Seneca, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.