Individual provider Active NPI

Austin Amasowomwan, DNP

  • Registered Nurse
  • Sacramento, CA
National Provider Identifier
1003152109
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
823194 Issued in CA
Practice address
PO Box 231185
Sacramento, CA 95823-0403
Phone
(916) 320-7699
NPI assigned
Dec 17, 2012
Reactivated
Nov 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X 95002682 CA
Registered Nurse 163W00000X 823194 CA Primary

Addresses

Primary practice location

PO Box 231185
Sacramento, CA 95823-0403

Mailing address

PO Box 231185
Sacramento, CA 95823-0403
Phone (916) 320-7699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260310004346 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789167503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

6600 Bruceville Rd
Sacramento, CA 95823-4671
Phone (916) 688-2000

Hospital & facility affiliations

  • Kaiser Foundation Hosp So Sacramento Hospital, Sacramento, CA, CCN 050674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
823194CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Jan 25, 2026 Accepting new patients
Permanente Medical Group Inc Multi-Specialty CurrentSince Jan 25, 2026 Accepting new patients

Locations

6600 Bruceville Rd
Sacramento, CA 95823

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.

Hospital & facility affiliations 1

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": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1003152109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 231185",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958230403",
            "telephone_number": "916-320-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 231185",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958230403",
            "telephone_number": "916-320-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMASOWOMWAN",
        "first_name": "AUSTIN",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-17",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "deactivation_date": "2017-11-22",
        "reactivation_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95002682",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "823194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.