Individual provider Active NPI

Simarpreet Kaur Sandhu, FNP

  • Family Nurse Practitioner
  • Peoria, AZ
National Provider Identifier
1992132773
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP5197 Issued in AZ
Practice address
9171 W Thunderbird Rd
Suite 101
Peoria, AZ 85381-4872
Phone
(623) 815-7800
Fax
(623) 815-7900
NPI assigned
Oct 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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 AP5197 AZ Primary

Addresses

Primary practice location

9171 W Thunderbird Rd
Suite 101
Peoria, AZ 85381-4872

Mailing address

9171 W Thunderbird Rd
Suite 101
Peoria, AZ 85381-4872
Phone (623) 815-7800

Other identifiers 2

IdentifierTypeStateIssuer
Z157950OtherAZGROUP PTAN
790980OtherAZGROUP TPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20140108000354 AZ Practitioner - Nurse Practitioner 1951539451 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leading Healthcare PLLCGroup PAC ID 1850652496, 42 clinicians

Practice addresses (Care Compare)

22922 N 40TH PL
Phoenix, AZ 85050-8742
Phone (347) 309-3320

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
4C Medical Group PLC PastSince May 1, 2017 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1381449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1992132773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9171 W THUNDERBIRD RD",
            "address_2": "SUITE 101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814872",
            "telephone_number": "623-815-7800",
            "fax_number": "623-815-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9171 W THUNDERBIRD RD",
            "address_2": "SUITE 101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814872",
            "telephone_number": "623-815-7800",
            "fax_number": "623-815-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHU",
        "first_name": "SIMARPREET",
        "middle_name": "KAUR",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-11",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP5197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "Z157950",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TPI",
            "identifier": "790980",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.