NPIMap

Organization Active NPI

Javier Amu,M.D. Professional Corporation

  • Specialist
National Provider Identifier
1346491651
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A81420 Issued in CA
Legal business name
JAVIER AMU,M.D. PROFESSIONAL CORPORATION
Practice address
1093 11TH St
Reedley, CALIFORNIA 93654
UM
Phone
(559) 743-7340
Fax
(559) 743-7395
NPI assigned
Oct 6, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Javier Amu, M.D.
Title
Medical Director
Phone
(559) 743-7340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A81420 CA Primary

Addresses

Primary practice location

1093 11TH St
Reedley, CALIFORNIA 93654
UM

Mailing address

1093 11TH St
Reedley, CA 93654-2950
Phone (559) 743-7340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081209000693 CA Part A Provider - Rural Health Clinic 4789745779 Practice locations: Reedley, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346491651. Details of each certification follow.

Rural health clinic certification: CCN 058938

Legal name
JAVIER AMU,M.D. PROFESSIONAL CORPORATION
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 20, 2009
Last certification
Aug 22, 2019
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Mar 20, 2003 in CA
Enrollment address
1093 11TH St
Reedley, CA 93654-2950

National Provider Directory

National Provider Directory

Locations

1093 11th St
Reedley, CA 93654
Phone (559) 743-7340

1121 F St
Reedley, CA 93654
Phone (559) 743-7340

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Toni Macabeo Individual Corporate OfficerSecretary Jun 26, 2017
W-2 Managing EmployeeSecretary Sep 15, 2015
Javier Amu Individual 5% Or Greater Direct Ownership InterestPresident Dec 15, 2008

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1346491651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1093 11TH ST",
            "city": "REEDLEY",
            "state": "CA",
            "postal_code": "936542950",
            "telephone_number": "559-743-7340",
            "fax_number": "559-743-7395"
        },
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "1093 11TH ST",
            "city": "REEDLEY",
            "state": "CALIFORNIA",
            "postal_code": "93654",
            "telephone_number": "559-743-7340",
            "fax_number": "559-743-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAVIER AMU,M.D. PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "AMU",
        "authorized_official_first_name": "JAVIER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "559-743-7340",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A81420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.