Individual provider Active NPI

Moninder Kaur Dhillon, MD

  • Family Medicine Physician
  • Tuscaloosa, AL
National Provider Identifier
1740808740
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
83183 Issued in WI
Practice address
850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457
Phone
(205) 348-1770
NPI assigned
Jul 7, 2020
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 83183 WI Primary

Addresses

Primary practice location

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457

Mailing address

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457
Phone (205) 348-1770

Other practice location 1

3200 E Racine St
Janesville, WI 53546-2343
Phone (608) 371-8000

Other identifiers 1

IdentifierTypeStateIssuer
1740808740MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mdhillon504479@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20240306000553 WI Practitioner - Family Practice 3678984440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

3200 E Racine St
Janesville, WI 53546-2343
Phone (608) 371-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc Family Medicine CurrentSince Feb 21, 2024 Accepting new patients
Dean Health Systems, Inc. CurrentSince Feb 21, 2024 Accepting new patients

Locations

3200 E Racine St
Janesville, WI 53546
Phone (608) 371-8000

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1740808740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017457",
            "telephone_number": "205-348-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017457",
            "telephone_number": "205-348-1770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 E Racine St",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535462343",
            "country_code": "US",
            "telephone_number": "608-371-8000",
            "fax_number": "608-371-8938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DHILLON",
        "first_name": "MONINDER",
        "middle_name": "KAUR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "83183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740808740",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdhillon504479@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mdhillon504479@direct-ehr-ssmhc.com",
            "address_1": "3200 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3200 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.