Individual provider Active NPI

Amelia Star Eastman, D.O.

  • Physical Medicine & Rehabilitation Physician
  • La Jolla, CA
National Provider Identifier
1336393990
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
20A 11643 Issued in CA
Practice address
9350 Campus Point Dr
Ste. 1B
La Jolla, CA 92037-1300
Phone
(858) 657-8200
Fax
(858) 657-8235
NPI assigned
Nov 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 20A11643 CA
Physical Medicine & Rehabilitation Physician 208100000X 20A 11643 CA Primary

Addresses

Primary practice location

9350 Campus Point Dr
Ste. 1B
La Jolla, CA 92037-1300

Mailing address

PO Box 232410
San Diego, CA 92193-2410
Phone (858) 249-6749

Other identifiers 1

IdentifierTypeStateIssuer
FU580AOtherCAMEDICARE PTAN

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
I20120223000134 CA Practitioner - Physical Medicine and Rehabilitation 0840458709 Reassigns benefits to 2 organizations
Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 3577476761, shared by 18 NPIs, 2,047 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-1910
Phone (858) 657-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A 11643CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

1200 Garden View Rd
Ste 100
Encinitas, CA 92024
Phone (760) 436-6188

1200 Garden View Rd
Encinitas, CA 92024
Phone (760) 536-7682

9350 Campus Point Dr
La Jolla, CA 92037
Phone (858) 657-0583

9350 Campus Point Dr
Ste Lld
La Jolla, CA 92037

9350 Campus Point Dr
Ste 1B
La Jolla, CA 92037
Phone (858) 657-8200

9400 Campus Point Dr
La Jolla, CA 92093
Phone (858) 249-3800

4520 Executive Dr
San Diego, CA 92121
Phone 8584505900103

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

4520 Executive Dr
Ste 1
San Diego, CA 92121

Organizations & group practices 6

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 1

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": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1336393990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "858-249-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 CAMPUS POINT DR",
            "address_2": "STE. 1B",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371300",
            "telephone_number": "858-657-8200",
            "fax_number": "858-657-8235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTMAN",
        "first_name": "AMELIA",
        "middle_name": "STAR",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CA",
            "license": "20A11643",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "20A 11643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "FU580A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.