Active NPI
Jeena D Amaya
- Physician Assistant
- Rockville, MD
National Provider Identifier
1396201968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C07043
- Practice address
- 7955 Tuckerman LN
Rockville, MD 20854-3243 - Phone
- (301) 299-3717
- NPI assigned
- Feb 19, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C07043 | MD | Primary |
Addresses
Primary practice location
7955 Tuckerman LN
Rockville, MD 20854-3243
Mailing address
14732 Pebble Hill LN
North Potomac, MD 20878-2447
Phone (240) 413-4080
Other practice location 1
11406 Georgia Ave Ste F
Wheaton, MD 20902-1944
Phone (301) 200-2230
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575936000000",
"number": "1396201968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14732 PEBBLE HILL LN",
"city": "NORTH POTOMAC",
"state": "MD",
"postal_code": "208782447",
"telephone_number": "240-413-4080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7955 TUCKERMAN LN",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208543243",
"telephone_number": "301-299-3717"
}
],
"practiceLocations": [
{
"address_1": "11406 Georgia Ave Ste F",
"address_purpose": "LOCATION",
"city": "Wheaton",
"state": "MD",
"postal_code": "209021944",
"country_code": "US",
"telephone_number": "301-200-2230",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AMAYA",
"first_name": "JEENA",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-19",
"last_updated": "2019-12-10",
"certification_date": "2019-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C07043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.