Amanda Allen, PA-C
Individual provider Active NPI Physician Assistant · Tustin, CA
NPI 1083477152 · NPPES record last updated Apr 15, 2024
Key facts
- NPI
- 1083477152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 18302 Irvine Blvd Ste 200
Tustin, CA 92780-3464 - Phone
- (949) 825-7650
- NPI assigned
- Feb 1, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Lamia L Gabal MD Inc
Practice addresses (Care Compare)
18302 Irvine Blvd
Suite 200
Tustin, CA 92780-3464
Phone (949) 825-7650
720 N Tustin Ave
Suite 104
Santa Ana, CA 92705-3606
Phone (949) 825-7650
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240419001657 | CA | Practitioner - Physician Assistant | 4082053202 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Interoperability endpoints
- amandaallen@pmg-ca.direct.office.nextgen.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
18302 Irvine Blvd Ste 200
Tustin, CA 92780-3464
Mailing address
18302 Irvine Blvd Ste 200
Tustin, CA 92780-3464
Phone (949) 825-7650
Other providers in Tustin, CA
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- All Natural Acupuncture & Herbs Inc
- All Things Relationship Inc
- Kevin Allard
- Allergy, Asthma & Respiratory Care
- Allied Medical Supply, Inc
- Allied Surgery Center
- Allo Integrative Health Center
- Nicole Allred
All providers in Tustin, CA · Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.