Individual provider Active NPI

Gurinder Grewal, M.D.

  • Cardiovascular Disease Physician
  • Tracy, CA
National Provider Identifier
1942389580
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
00A376090 Issued in CA
Practice address
530 W Eaton Ave Ste a
Tracy, CA 95376-3454
Phone
(209) 836-0364
Fax
(209) 836-2057
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 00A376090 CA Primary

Addresses

Primary practice location

530 W Eaton Ave Ste a
Tracy, CA 95376-3454

Mailing address

530 W Eaton Ave Ste a
Tracy, CA 95376-3454
Phone (209) 836-0364

Other identifiers 2

IdentifierTypeStateIssuer
060027309OtherCARAILROAD MEDICARE
00A376090MedicaidCA

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
I20080228000273 CA Practitioner - Cardiovascular Disease (Cardiology) 6709960826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00A376090CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Joaquin Cardiology Medical Group Inc Cardiovascular Disease CurrentSince Sep 1, 2007 Accepting new patients
Port City Operating Company, LLC Past Accepting new patients
St. Joseph's Hospital, Yonkers Past Accepting new patients
Dameron Hospital Association Cardiovascular Disease Past Accepting new patients
Stockton Cardiology Medical Group Complete Heart Care Inc Cardiovascular Disease PastSince Sep 1, 2007 Accepting new patients
Sutter Tracy Community Hospital Past Accepting new patients

Locations

900 S Fairmont Ave
Ste C
Lodi, CA 95240
Phone (209) 334-9911

2800 N California St
Ste 14A
Stockton, CA 95204
Phone (209) 464-7681

2800 N California St
Ste 1
Stockton, CA 95204
Phone (209) 942-1161

2800 N California St
Ste 14
Stockton, CA 95204
Phone (209) 464-2605

2800 N California St
Ste 3
Stockton, CA 95204
Phone (209) 948-2828

530 W Eaton Ave
Ste A
Tracy, CA 95376
Phone (209) 565-1070

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ggrewal30426@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1942389580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 W EATON AVE STE A",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763454",
            "telephone_number": "209-836-0364",
            "fax_number": "209-836-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 W EATON AVE STE A",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763454",
            "telephone_number": "209-836-0364",
            "fax_number": "209-836-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "GURINDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "00A376090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060027309",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A376090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

Verify at the official NPI Registry.