Individual provider Active NPI

Amanda Hannah Thorson, DO

  • Obstetrics & Gynecology Physician
  • San Luis Obispo, CA
National Provider Identifier
1366904575
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
21016 Issued in CA
Practice address
1941 Johnson Ave Ste 301
San Luis Obispo, CA 93401-4175
Phone
(805) 786-4111
Fax
(805) 543-6357
NPI assigned
Apr 5, 2019
Last updated
Dec 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 21016 CA Primary

Addresses

Primary practice location

1941 Johnson Ave Ste 301
San Luis Obispo, CA 93401-4175

Mailing address

1941 Johnson Ave Ste 301
San Luis Obispo, CA 93401-4175
Phone (805) 789-4111

Other practice location 1

350 Posada Ln Ste 202
Templeton, CA 93465-4060
Phone (805) 434-5497

Other names 1

  • Amanda Hannah Popish Former name

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
I20230908001999 CA Practitioner - Obstetrics/Gynecology 0345604328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1941 Johnson Ave
Suite 301
San Luis Obispo, CA 93401-4175
Phone (805) 786-4111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21016CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers Current Accepting new patients
Pacific Central Coast Health Centers CurrentSince Sep 18, 2023 Accepting new patients
Pacific Central Coast Health Centers CurrentSince Sep 18, 2023 Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

500 Old River Rd
Ste 200
Bakersfield, CA 93311
Phone (661) 663-6429

2901 N Ventura Rd
Ste 110
Oxnard, CA 93036
Phone (805) 981-6163

117 W Bunny Ave
Santa Maria, CA 93458
Phone (805) 739-3474

1414 E Main St
Ste 201
Santa Maria, CA 93454
Phone (805) 739-3112

1510 E Main St
Ste 104C
Santa Maria, CA 93454
Phone (805) 349-8514

1941 Johnson Ave
Ste 301
Sn Luis Obisp, CA 93401
Phone (805) 597-6715

350 Posada Ln
Ste 202
Templeton, CA 93465
Phone (805) 434-5497

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: athorson290365@ahs.direct-ci.com

Organizations & group practices 5

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": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1366904575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 JOHNSON AVE STE 301",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014175",
            "telephone_number": "805-789-4111",
            "fax_number": "805-543-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 JOHNSON AVE STE 301",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014175",
            "telephone_number": "805-786-4111",
            "fax_number": "805-543-6357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Posada Ln Ste 202",
            "address_purpose": "LOCATION",
            "city": "Templeton",
            "state": "CA",
            "postal_code": "934654060",
            "country_code": "US",
            "telephone_number": "805-434-5497",
            "fax_number": "805-434-0917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORSON",
        "first_name": "AMANDA",
        "middle_name": "HANNAH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "21016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "POPISH",
            "middle_name": "HANNAH",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.