Individual provider Active NPI

Margaret Akua Amoo, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Grand Terrace, CA
National Provider Identifier
1164057022
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95013762 Issued in 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
Last updated
Nov 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95013762 CA Primary

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 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210630001931 CA Practitioner - Nurse Practitioner 8426459272 Reassigns benefits to 2 organizations
I20221201001643 TX Practitioner - Nurse Practitioner 8426459272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of RiversideGroup PAC ID 6507754488, 190 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95013762CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside Current Accepting new patients
Minuteclinic Diagnostic Medical Group of Orange County Inc Family CurrentSince Apr 21, 2021 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. Current Accepting new patients
Riverside-San Bernardino County Indian Health, Inc CurrentSince Nov 4, 2022 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. CurrentSince Nov 4, 2022 Accepting new patients
County of Riverside CurrentSince May 1, 2023 Accepting new patients
County of Riverside CurrentSince May 1, 2023 Accepting new patients
Alfaro-McField Medical Clinic Inc PastSince Mar 1, 2020 Accepting new patients

Locations

11555 Potrero Rd
#1-2
Banning, CA 92220
Phone (800) 732-8805

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

  • Direct secure messaging: mamoo718448@direct.llu.edu

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1164057022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11980 MOUNT VERNON AVE",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135172",
            "telephone_number": "909-864-1097",
            "fax_number": "951-225-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11980 MOUNT VERNON AVE",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135172",
            "telephone_number": "909-864-1097",
            "fax_number": "951-225-6879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMOO",
        "first_name": "MARGARET",
        "middle_name": "AKUA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-11",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95013762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "55 Maui Lani Pkwy",
            "city": "Wailuku",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967932416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Terrace, CA

Sources for this page

Verify at the official NPI Registry.