Jason Russel D'Amico, LPT

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1030 W Warner Ave
Santa Ana, CA 92707-3147

Phone

(714) 834-6900

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• HCA BH LPS MHS

  • Case Management Agency
  • Santa Ana, CA
  • NPI 1689766800
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1184722316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W 5TH ST STE 550",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014519",
            "telephone_number": "714-834-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 W WARNER AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927073147",
            "telephone_number": "714-834-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AMICO",
        "first_name": "JASON",
        "middle_name": "RUSSEL",
        "name_prefix": "Mr.",
        "credential": "LPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT27519",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.