Individual provider Active NPI

Daniel Amde, M.D,

  • Internal Medicine Physician
  • Van Nuys, CA
National Provider Identifier
1316218456
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A121962 Issued in CA
Practice address
15107 Vanowen St
Van Nuys, CA 91405-4542
Phone
(818) 325-0200
Fax
(818) 325-0210
NPI assigned
Jan 20, 2012
Last updated
May 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A121962 CA Primary

Addresses

Primary practice location

15107 Vanowen St
Van Nuys, CA 91405-4542

Mailing address

4955 Van Nuys Blvd
Suite 502
Sherman Oaks, CA 91403-1801
Phone (818) 325-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130807000508 CA Practitioner - Internal Medicine 9638311442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Howard University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Fernando Valley Medical Group IncGroup PAC ID 9931360047, 13 clinicians

Practice addresses (Care Compare)

4955 Van Nuys Blvd
Suite 502
Sherman Oaks, CA 91403-1801
Phone (818) 325-0200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
San Fernando Valley Medical Group Inc Internal Medicine CurrentSince Aug 1, 2013 Accepting new patients

Locations

4955 Van Nuys Blvd
Ste 502
Sherman Oaks, CA 91403
Phone (818) 325-0200

15107 Vanowen St
Van Nuys, CA 91405
Phone (818) 782-6600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1316218456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD",
            "address_2": "SUITE 502",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031801",
            "telephone_number": "818-325-0200",
            "fax_number": "818-325-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15107 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054542",
            "telephone_number": "818-325-0200",
            "fax_number": "818-325-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMDE",
        "first_name": "DANIEL",
        "credential": "M.D,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-20",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A121962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.