Active NPI
Amanda Haiman Gersich, M.D.
- Health Educator
- East Palo Alto, CA
National Provider Identifier
1467539460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- Practice address
- 1885 Bay Rd
East Palo Alto, CA 94303-1312 - Phone
- (650) 330-7400
- Fax
- (650) 321-1156
- NPI assigned
- Nov 1, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A066013 | CA | |
| Health Educator | 174H00000X | Primary |
Addresses
Primary practice location
1885 Bay Rd
East Palo Alto, CA 94303-1312
Mailing address
1885 Bay Rd
East Palo Alto, CA 94303-1312
Phone (650) 330-7400
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A066013 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LPCH Medical Group Div of Lucile | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657152000000",
"number": "1467539460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1885 BAY RD",
"city": "EAST PALO ALTO",
"state": "CA",
"postal_code": "943031312",
"telephone_number": "650-330-7400",
"fax_number": "650-321-1156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1885 BAY RD",
"city": "EAST PALO ALTO",
"state": "CA",
"postal_code": "943031312",
"telephone_number": "650-330-7400",
"fax_number": "650-321-1156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAIMAN GERSICH",
"first_name": "AMANDA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2022-07-07",
"certification_date": "2022-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A066013",
"primary": false
},
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.