Individual provider Active NPI

Kiranjot Kaur Gill, NP

  • Nurse Practitioner
  • Bellevue, WA
National Provider Identifier
1962779041
Registry record updated Jun 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
21047 Issued in CA
Practice address
1400 112TH Ave SE Ste 100
Bellevue, WA 98004-6901
Phone
(425) 357-7248
Fax
(425) 270-1516
NPI assigned
Nov 17, 2011
Last updated
Jun 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 21047 CA Primary
Nurse Practitioner 363L00000X AP60282818 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60282818 WA

Addresses

Primary practice location

1400 112TH Ave SE Ste 100
Bellevue, WA 98004-6901

Mailing address

1400 112TH Ave SE Ste 100
Bellevue, WA 98004-6901
Phone (425) 357-7248

Other practice location 1

1801 W Romneya Dr
Ste 203
Anaheim, CA 92801-1830
Phone (714) 999-1465

Other practice location 2

8920 Wilshire Blvd Ste 425
Beverly Hills, CA 90211-2004
Phone (310) 746-4395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 1, 2026 through Oct 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
21047CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Soundpath Psychiatry PLLC Current Accepting new patients
Mark David Levine, MD Burlingame PC PastSince Sep 1, 2019 Accepting new patients

Locations

1400 112th Ave SE
Ste 100
Bellevue, WA 98004
Phone (425) 455-2526

2105 112th Ave NE
Ste 201
Bellevue, WA 98004
Phone (425) 770-0190

Interoperability endpoints

  • Direct secure messaging: kiranjot.gill@kcc.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654387200000",
    "number": "1962779041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 112TH AVE SE STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046901",
            "telephone_number": "425-357-7248",
            "fax_number": "425-270-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 112TH AVE SE STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046901",
            "telephone_number": "425-357-7248",
            "fax_number": "425-270-1516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W Romneya Dr",
            "address_2": "STE 203",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928011830",
            "country_code": "US",
            "telephone_number": "714-999-1465",
            "fax_number": "714-999-1701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8920 Wilshire Blvd Ste 425",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902112004",
            "country_code": "US",
            "telephone_number": "310-746-4395",
            "fax_number": "310-432-7065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "KIRANJOT",
        "middle_name": "KAUR",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-17",
        "last_updated": "2022-06-05",
        "certification_date": "2022-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "21047",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60282818",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60282818",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.