Individual provider Active NPI

Pawandeep Kaur Virk, MD

  • Family Medicine Physician
  • Tracy, CA
National Provider Identifier
1790366920
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A191985 Issued in CA
Practice address
1470 Bessie Ave
Tracy, CA 95376-3417
Phone
(209) 833-0525
NPI assigned
Apr 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A191985 CA Primary

Addresses

Primary practice location

1470 Bessie Ave
Tracy, CA 95376-3417

Mailing address

603 W Sombra Way
Mountain House, CA 95391-2097
Phone (510) 910-3808

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
I20241219000678 CA Practitioner - Family Practice 5395272090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premiercare Physicians a California General PartnershipGroup PAC ID 5799113031, 5 clinicians

Practice addresses (Care Compare)

1470 Bessie Ave
Tracy, CA 95376-3417
Phone (209) 883-0525

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A191985CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premiercare Physicians a California General Partnership Family Medicine CurrentSince Oct 18, 2024 Accepting new patients

Locations

1144 Norman Dr
Ste 204
Manteca, CA 95336
Phone (209) 665-4252

531 W Yosemite Ave
Manteca, CA 95337
Phone (209) 833-0525

1470 Bessie Ave
Tracy, CA 95376
Phone (209) 833-0525

Interoperability endpoints

  • Direct secure messaging: pvirk228603@hpmg.direct-ci.net
  • Direct secure messaging: pvirk690325@hisp.ehr.sutterhealth.org

Organizations & group practices 1

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 3

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": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1790366920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 W SOMBRA WAY",
            "city": "MOUNTAIN HOUSE",
            "state": "CA",
            "postal_code": "953912097",
            "telephone_number": "510-910-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 BESSIE AVE",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763417",
            "telephone_number": "209-833-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRK",
        "first_name": "PAWANDEEP",
        "middle_name": "KAUR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A191985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

Verify at the official NPI Registry.