Margaret Akua Amoo, NURSE PRACTITIONER
Individual provider Active NPI Family Nurse Practitioner · Grand Terrace, CA
NPI 1164057022 · NPPES record last updated Nov 8, 2022
Key facts
- NPI
- 1164057022
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- NP95013762 (CA)
- Practice address
- 11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172 - Phone
- (909) 864-1097
- Fax
- (951) 225-6879
- NPI assigned
- Mar 11, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 26
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Riverside-San Bernardino County Indian Health Inc
County of Riverside
Practice addresses (Care Compare)
11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172
Phone (909) 864-1097
23119 Soboba Rd
San Jacinto, CA 92583-5517
Phone (951) 654-0803
2499 E Lakeshore Dr
Lake Elsinore, CA 92530-4411
Phone (951) 471-4200
2813 S Main St
Corona, CA 92882-5942
Phone (951) 272-5445
31760 Casino Dr
Lake Elsinore, CA 92530-4561
Phone (951) 943-8015
31764 Casino Dr
Lake Elsinore, CA 92530-4571
Phone (951) 943-8015
47001 Pala Rd
Temecula, CA 92592-2925
Phone (951) 676-6810
48360 Pechanga Rd
Temecula, CA 92592-2986
Phone (951) 676-6810
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, TX
- 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 |
|---|---|---|---|---|
| I20210630001931 | CA | Practitioner - Nurse Practitioner | 8426459272 | Reassigns benefits to 2 organizations |
| I20221201001643 | TX | Practitioner - Nurse Practitioner | 8426459272 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP95013762 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Riverside | Current |
Accepting new patients | |
| Minuteclinic Diagnostic Medical Group of Orange County Inc | Family | Current |
Accepting new patients |
| County of Riverside | Current | Accepting new patients | |
| Riverside-San Bernardino County Indian Health, Inc. | Current |
Accepting new patients | |
| County of Riverside | Current |
Accepting new patients | |
| Riverside-San Bernardino County Indian Health, Inc. | Current | Accepting new patients | |
| Riverside-San Bernardino County Indian Health, Inc | Current |
Accepting new patients | |
| Alfaro-McField Medical Clinic Inc | Past |
Accepting new patients |
Locations
11555 Potrero Rd
#1-2
Banning, CA 92220
Phone (909) 849-4761
11980 Mount Vernon Ave
Grand Terrace, CA 92313
Phone (909) 783-8470
308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700
11428 Kenyon Way
Rancho Cucamonga, CA 91701
Phone (909) 589-4098
491 E Alessandro Blvd
Riverside, CA 92508
Phone (951) 780-1835
921 Pacific Coast Hwy
Seal Beach, CA 90740
Phone (562) 598-0473
33205 US Highway 79
Temecula, CA 92592
Phone (951) 303-3154
Interoperability endpoints
- mamoo718448@direct.llu.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP95013762 | CA | Yes |
Addresses
Primary practice location
11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172
Mailing address
11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172
Phone (909) 864-1097
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Other providers in Grand Terrace, CA
- Jada Albizures
- Uchechukwu Adaure Alozie
- Alternative Choices, Inc.
- Alternative Choices, Inc.
- Alternative Choices, Inc.
- Kwame Amponsah
- Njideka Obioma Anazodo
- Lia M Andrews
- Nina G Andrews
- Christian Hernandez Aniag
All providers in Grand Terrace, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2022. 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.