Individual provider Active NPI

Amanda Rose Van Mecl, DO

  • Internal Medicine Physician
  • San Bernardino, CA
National Provider Identifier
1043714090
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A18969 Issued in CA
Practice address
2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone
(909) 881-4520
NPI assigned
Mar 22, 2018
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A18969 CA Primary

Addresses

Primary practice location

2101 N Waterman Ave
San Bernardino, CA 92404-4836

Mailing address

2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone (909) 881-4520

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230714001912 CA Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 0840527743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine
Education
Lake Erie Col of Osteopathic Medicine, Bradenton, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Specialists of California PCGroup PAC ID 3476864448, 373 clinicians

Practice addresses (Care Compare)

2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone (909) 883-8711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A18969CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Jun 1, 2023 Accepting new patients

Locations

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

Organizations & group practices 1

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 2

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": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1043714090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044836",
            "telephone_number": "909-881-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044836",
            "telephone_number": "909-881-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN MECL",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A18969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.