Individual provider Active NPI

Amber Heckart Gilmore, MD

  • Family Medicine Physician
  • Ukiah, CA
National Provider Identifier
1407210768
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A169012 Issued in CA
Practice address
260 Hospital Dr Ste 103
Ukiah, CA 95482-4568
Phone
(707) 463-7470
NPI assigned
Apr 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 82249 SC
Family Medicine Physician 207Q00000X 2017-01980 NC
Family Medicine Physician 207Q00000X A169012 CA Primary

Addresses

Primary practice location

260 Hospital Dr Ste 103
Ukiah, CA 95482-4568

Mailing address

260 Hospital Dr Ste 103
Ukiah, CA 95482-4568
Phone (707) 463-7470

Other identifiers 6

IdentifierTypeStateIssuer
SCF4033365OtherSCMEDICARE PIN
SCF4036084OtherSCMEDICARE PIN
822499MedicaidSC
SCF4036121OtherSCMEDICARE PIN
SCF4036067OtherSCMEDICARE PIN
SCF403J577OtherSCMEDICARE PIN

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
I20200901002688 CA Practitioner - Family Practice 2264726041 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consolidated Tribal Health Project, Inc.Group PAC ID 1456260736, 11 clinicians

Practice addresses (Care Compare)

6991 N State St
Redwood Valley, CA 95470-9629
Phone (707) 467-5620

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.4 of 100Reported as group
Quality
65.6
Improvement activities
40
Cost
71.06

Merit-based Incentive Payment System (MIPS)

Final score
89.41 of 100Reported as group
Quality
86.32
Promoting interoperability
95
Improvement activities
40
Cost
66.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A169012CAMDFamily Medicine Physician
2017-01980NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians, PC Current Accepting new patients
Consolidated Tribal Health Project, Inc. CurrentSince Oct 15, 2020 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Jun 1, 2022 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Jun 1, 2022 Accepting new patients
Pacific Redwood Medical Group Inc Family Medicine CurrentSince Oct 1, 2020 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

6991 N State St
Redwood Vly, CA 95470
Phone (707) 467-5620

869 N Cherry St
Tulare, CA 93274
Phone (559) 326-2800

275 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-7900

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

Interoperability endpoints

  • Direct secure messaging: amber.gilmore.1@15156.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/15156/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1407210768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 103",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824568",
            "telephone_number": "707-463-7470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 103",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824568",
            "telephone_number": "707-463-7470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "AMBER",
        "middle_name": "HECKART",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "82249",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2017-01980",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A169012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCF4033365",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCF4036084",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "822499",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCF4036121",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCF4036067",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCF403J577",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

Verify at the official NPI Registry.