Individual provider Active NPI

Amanda Hanhan Massad, MD

  • Family Medicine Physician
  • San Francisco, CA
National Provider Identifier
1467940825
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A174836 Issued in CA
Practice address
1580 Valencia St Ste 201
San Francisco, CA 94110-4420
Phone
(415) 550-0811
Fax
(415) 550-0877
NPI assigned
May 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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 R-11667 IA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X A174836 CA Primary

Addresses

Primary practice location

1580 Valencia St Ste 201
San Francisco, CA 94110-4420

Mailing address

1580 Valencia St Ste 201
San Francisco, CA 94110-4420
Phone (415) 550-0811

Other names 1

  • Amanda Hanhan Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL amassad@btmg.com

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
I20211001002175 CA Practitioner - Family Practice 6800226960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

395 Hickey Blvd
Daly City, CA 94015-2770
Phone (650) 301-5860

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A174836CAMDFamily Medicine Physician
R-11667IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
My Health Medical Group Inc Family Medicine CurrentSince Nov 1, 2021 Accepting new patients
California Pacific Medical Group, Inc. PastSince Nov 1, 2021 Accepting new patients

Locations

901 Campus Dr
Ste 214
Daly City, CA 94015
Phone (415) 785-4246

535 E Romie Ln
Ste 2
Salinas, CA 93901
Phone (831) 424-6679

1580 Valencia St
Ste 201
San Francisco, CA 94110
Phone (415) 550-0811

Interoperability endpoints

  • Direct secure messaging: amanda.massad.1@24668.direct.athenahealth.com

Organizations & group practices 3

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 5

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": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1467940825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 VALENCIA ST STE 201",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941104420",
            "telephone_number": "415-550-0811",
            "fax_number": "415-550-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 VALENCIA ST STE 201",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941104420",
            "telephone_number": "415-550-0811",
            "fax_number": "415-550-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSAD",
        "first_name": "AMANDA",
        "middle_name": "HANHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-11667",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A174836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "amassad@btmg.com",
            "affiliation": "N",
            "address_1": "1580 Valencia St Ste 201",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941104420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "HANHAN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.