Individual provider Active NPI

Amanda Wittmann, CRNA

  • Certified Registered Nurse Anesthetist
  • Roseville, CA
National Provider Identifier
1477039535
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95000922 Issued in CA
Practice address
1600 Eureka Rd
Roseville, CA 95661-3027
Phone
(916) 784-4000
NPI assigned
Jul 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 95000922 CA Primary

Addresses

Primary practice location

1600 Eureka Rd
Roseville, CA 95661-3027

Mailing address

3350 Sky LN
Shingle Springs, CA 95682-8815
Phone (614) 537-8610

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190904001233 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072842897 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

4001 J St
Sacramento, CA 95819-3626
Phone (916) 453-4545

Hospital & facility affiliations

  • Mercy General Hospital Hospital, Sacramento, CA, CCN 050017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95000922CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia PC CurrentSince Dec 1, 2023 Accepting new patients
Cep America - Anesthesia, PC Current Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Folsom Anesthesia LP Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2025 Accepting new patients
Cep America - Anesthesia PC CurrentSince Dec 1, 2023 Accepting new patients
Permanente Medical Group, Inc CurrentSince Jul 8, 2019 Accepting new patients
Permanente Medical Group Inc CurrentSince Jul 8, 2019 Accepting new patients
Dignity Health Past Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1671 Creekside Dr
Ste 100
Folsom, CA 95630
Phone (214) 739-9544

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

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

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

1600 Eureka Rd
Roseville, CA 95661
Phone (916) 474-7777

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 8

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": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1477039535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 SKY LN",
            "city": "SHINGLE SPRINGS",
            "state": "CA",
            "postal_code": "956828815",
            "telephone_number": "614-537-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 EUREKA RD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613027",
            "telephone_number": "916-784-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTMANN",
        "first_name": "AMANDA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95000922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1600 Eureka Rd",
            "city": "Roseville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956613027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.