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LODI ADVANCED MEDICAL CENTER PC
NPI 1285361188
Nurse Practitioner in Lodi, CA

Active since August 02, 2022
1420 W KETTLEMAN LN STE K1, LODI, CA 95242(209) 368-0619 Get Directions Write a Review

NPPES record last updated: March 8, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Mar 8, 2023, Aug 17, 2022, Aug 5, 2022 (3 updates tracked since 2022).

About Lodi Advanced Medical Center Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LODI ADVANCED MEDICAL CENTER PC (NPI 1285361188) is a healthcare organization registered as a nurse practitioner in Lodi, California and active in the NPI registry since August 2022. The organization lists Kevin Stewart, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1285361188
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameLODI ADVANCED MEDICAL CENTER PC
Location Address1420 W KETTLEMAN LN STE K1Lodi, CA 95242-4559
Mailing Address1420 W Kettleman Ln Ste K1Lodi, CA 95242-4559 · (209) 368-0619
Phone(209) 368-0619
Organization SubpartNo
Authorized OfficialKevin StewartAuthorized Official · (209) 368-0619
Enumeration DateAugust 2, 2022
Last NPPES UpdateMarch 8, 20233 updates tracked since enumeration
NPPES CertifiedMarch 8, 2023
✔ NPI 1285361188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1420 W KETTLEMAN LN STE K1, Lodi, CA 95242
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lodi Advanced Medical Center Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Lodi Advanced Medical Center PC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Kevin Stewart, D.C
Chiropractic
NPI 1538246186
400 E KETTLEMAN LN STE 21
Lodi, CA 95240
(209) 368-0619
0.6 mi
Amandeep Dhaliwal, RN
Nurse Practitioner
NPI 1881324374
1923 COFFEE RD # 12
Modesto, CA 95355
(209) 409-8454
✔ PECOS✔ Accepts Medicare35 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lodi Advanced Medical Center PC's NPI number?

The NPI number for Lodi Advanced Medical Center PC is 1285361188. It was assigned to this organization in the NPPES registry on August 2, 2022.

Where is Lodi Advanced Medical Center PC located?

Lodi Advanced Medical Center PC is located at 1420 W Kettleman Ln Ste K1, Lodi, CA 95242. The listed phone number is (209) 368-0619.

What is Lodi Advanced Medical Center PC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Lodi Advanced Medical Center PC enrolled in Medicare?

Yes. Lodi Advanced Medical Center PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lodi Advanced Medical Center PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Lodi Advanced Medical Center PC, in Chiropractic and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Lodi Advanced Medical Center PC was last updated on March 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.