Active NPI
Amanda Goldstein, MD
- Psychiatry Physician
- Los Angeles, CA
National Provider Identifier
1154735355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A153385
- Practice address
- 760 Westwood PLZ Ste 37-384
Los Angeles, CA 90024-5055 - Phone
- (310) 825-1289
- Fax
- (310) 825-0340
- NPI assigned
- Jun 16, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 125-064926 | IL | |
| Psychiatry Physician | 2084P0800X | A153385 | CA | Primary |
Addresses
Primary practice location
760 Westwood PLZ Ste 37-384
Los Angeles, CA 90024-5055
Mailing address
760 Westwood PLZ Ste 37-384
Los Angeles, CA 90024-5055
Other practice location 1
5841 S Maryland Ave
MC 3077
Chicago, IL 60637-1447
Phone (773) 702-8595
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: Yes
- Opted out of Medicare
- Yes, effective Oct 16, 2020 through Oct 16, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A153385 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Ryan K. I. Davis, M.D., a Professional Corporation | Psychiatry | Past | Accepting new patients |
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.
-
- Psychiatry Physician
- Beverly Hills, CA
- NPI 1710420948
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574035200000",
"number": "1154735355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "760 WESTWOOD PLZ STE 37-384",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900245055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 WESTWOOD PLZ STE 37-384",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900245055",
"telephone_number": "310-825-1289",
"fax_number": "310-825-0340"
}
],
"practiceLocations": [
{
"address_1": "5841 S Maryland Ave",
"address_2": "MC 3077",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606371447",
"country_code": "US",
"telephone_number": "773-702-8595",
"fax_number": "773-702-6454",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOLDSTEIN",
"first_name": "AMANDA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-16",
"last_updated": "2019-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "125-064926",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A153385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.