Individual provider Active NPI

Amber Joy Rangel, PA-C, MPAP

  • Medical Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1043766363
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
53556 Issued in CA
Practice address
2990 S Sepulveda Blvd # 300
Los Angeles, CA 90064-0002
Phone
(323) 421-4747
NPI assigned
Aug 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 53556 CA Primary

Addresses

Primary practice location

2990 S Sepulveda Blvd # 300
Los Angeles, CA 90064-0002

Mailing address

P.O. Box 642292
11270 Exposition Blvd FL 1
Los Angeles, CA 90064
Phone (310) 999-9592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

115 E Ogden Ave
Naperville, IL 60563-3103

370 N Wiget LN
Suite 250
Walnut Creek, CA 94598-2454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53556CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Shanthimd Dermatology, Inc. PastSince Jan 29, 2016 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amber.rangel@398008301912068.direct.elationemr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1043766363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 642292",
            "address_2": "11270 EXPOSITION BLVD FL 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90064",
            "telephone_number": "310-999-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 S SEPULVEDA BLVD # 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900640002",
            "telephone_number": "323-421-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANGEL",
        "first_name": "AMBER",
        "middle_name": "JOY",
        "name_prefix": "Ms.",
        "credential": "PA-C, MPAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "53556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.