NPIMap

Organization Active NPI

Kuldip Gill M D P C

  • Internal Medicine Physician
  • Grass Valley, CA
National Provider Identifier
1932397601
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A061538 Issued in CA
Legal business name
KULDIP GILL M D P C
Doing business as
Kuldip Gill MD PC
Practice address
280 Sierra College Dr.
Suite 205
Grass Valley, CA 95945
Phone
(530) 274-8452
Fax
(530) 477-5182
NPI assigned
Oct 9, 2007
Last updated
Jul 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Authorized official

Name
Michelle Cammon
Title
Billing Manager
Phone
(530) 273-8452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A061538 CA Primary

Addresses

Primary practice location

280 Sierra College Dr.
Suite 205
Grass Valley, CA 95945

Mailing address

280 Sierra College Dr.
Suite 205
Grass Valley, CA 95945
Phone (530) 274-8452

Other names 1

  • Kuldip Gill MD PC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001754 CA Part B Supplier - Clinic/Group Practice 7911990023 Receives reassigned benefits from 11 practitioners
Practice locations: Grass Valley, CA; Loomis, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0943651Kuldip S Gill MD280 Sierra College Dr Ste 205, Spring Hill, CA 95945Certificate of waiverNov 22, 2027

National Provider Directory

National Provider Directory

Locations

108 Catherine Ln
Ste A
Grass Valley, CA 95945
Phone (530) 273-8452

280 Sierra College Dr
Ste 2
Grass Valley, CA 95945

3262 Penryn Rd
Ste 100
Loomis, CA 95650

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1932397601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 SIERRA COLLEGE DR.",
            "address_2": "SUITE 205",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "95945",
            "telephone_number": "530-274-8452",
            "fax_number": "530-477-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 SIERRA COLLEGE DR.",
            "address_2": "SUITE 205",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "95945",
            "telephone_number": "530-274-8452",
            "fax_number": "530-477-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KULDIP GILL M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "CAMMON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "530-273-8452"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A061538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kuldip Gill MD PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kuldip Gill MD PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.