Individual provider Active NPI

Amanda Renee Dupre, DO

  • Family Medicine Physician
  • Torrance, CA
National Provider Identifier
1467913194
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A19725 Issued in CA
Practice address
1000 W Carson St
Torrance, CA 90502-2004
Phone
(310) 222-2912
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.160815 IL
Family Medicine Physician 207Q00000X 20A19725 CA Primary

Addresses

Primary practice location

1000 W Carson St
Torrance, CA 90502-2004

Mailing address

3218 Willowbrook Ave
Palmdale, CA 93551-1034
Phone (818) 929-6415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220712001326 IL Practitioner - Family Practice 2466832118 Reassigns benefits to 3 organizations
I20231018003187 CA Practitioner - Family Practice 2466832118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

1401 S Grand Ave
Los Angeles, CA 90015-3010
Phone (213) 748-2411

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A19725CAMDFamily Medicine Physician
036.160815ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems Family Medicine CurrentSince Jun 5, 2023 Accepting new patients
Carle Health Care Incorporated Family Medicine CurrentSince Jan 6, 2026 Accepting new patients
Prohealth Partners a Medical Group Family Medicine CurrentSince Oct 1, 2023 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 8, 2022 Accepting new patients
Proctor Health Systems Family Medicine CurrentSince Jun 5, 2023 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 8, 2022 Accepting new patients
Prohealth Partners, a Medical Group Current Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Prohealth Partners, a Medical Group, Inc. Past Accepting new patients
Carle Health Care Incorporated Past Accepting new patients
Prohealth Partners a Medical Group Inc Family Medicine Past Accepting new patients

Locations

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555

1401 S Grand Ave
Ste 101
Los Angeles, CA 90015

4201 Torrance Blvd
Ste 350
Torrance, CA 90503
Phone (310) 540-5494

1776 Westlakes Pkwy
Ste 400
West Des Moines, IA 50266
Phone (515) 241-6161

2535 E Washington St
East Peoria, IL 61611
Phone (309) 694-6464

3591 Griffin Ave
Pekin, IL 61554
Phone (309) 353-1822

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

815 Main St
Ste A1
Peoria, IL 61602

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

3915 Barring Trce
Peoria, IL 61615
Phone (309) 689-3030

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: amanda.dupre.1@28334.direct.athenahealth.com

Organizations & group practices 11

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 1

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": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1467913194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3218 WILLOWBROOK AVE",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511034",
            "telephone_number": "818-929-6415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004",
            "telephone_number": "310-222-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPRE",
        "first_name": "AMANDA",
        "middle_name": "RENEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.160815",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A19725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.