Individual provider Active NPI

Hardeep Mundh

  • Family Nurse Practitioner
  • Live Oak, CA
National Provider Identifier
1982186508
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95009874 Issued in CA
Practice address
9792 Live Oak Blvd Ste E
Live Oak, CA 95953-2381
Phone
(530) 701-3131
Fax
(530) 237-0460
NPI assigned
Aug 30, 2018
Last updated
Dec 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95009874 CA Primary

Addresses

Primary practice location

9792 Live Oak Blvd Ste E
Live Oak, CA 95953-2381

Mailing address

9792 Live Oak Blvd Ste E
Live Oak, CA 95953-2381
Phone (530) 701-3131

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190110003198 CA Practitioner - Nurse Practitioner 9537405667 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mundh NP and Garretson MD Medical CorporationGroup PAC ID 6406245323, 2 clinicians

Practice addresses (Care Compare)

2794 Pennington Rd
Live Oak, CA 95953-2255
Phone (530) 538-8771

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95009874CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mundh NP & Garretson MD Medical Corporation CurrentSince Nov 1, 2021 Accepting new patients
Jasbir S Kang MD & Sanjiv Midha MD a Medical Corporation CurrentSince Sep 1, 2018 Accepting new patients

Locations

9792 Live Oak Blvd
Ste E
Live Oak, CA 95953
Phone (530) 538-8771

527 E St
Marysville, CA 95901
Phone (530) 674-2100

1215 Plumas St
Ste 1900
Yuba City, CA 95991
Phone (530) 674-2100

Organizations & group practices 3

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": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1982186508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9792 LIVE OAK BLVD STE E",
            "city": "LIVE OAK",
            "state": "CA",
            "postal_code": "959532381",
            "telephone_number": "530-701-3131",
            "fax_number": "530-237-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9792 LIVE OAK BLVD STE E",
            "city": "LIVE OAK",
            "state": "CA",
            "postal_code": "959532381",
            "telephone_number": "530-701-3131",
            "fax_number": "530-237-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDH",
        "first_name": "HARDEEP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-30",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, CA

Sources for this page

Verify at the official NPI Registry.