Active NPI
Amanda Welvaert
- Physician Assistant
- Auburn, CA
National Provider Identifier
1477860591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA21390
- Practice address
- 275 Grass Valley Hwy
Auburn, CA 95603-4533 - Phone
- (530) 885-0344
- NPI assigned
- Sep 10, 2010
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | PA21390 | CA | Primary |
Addresses
Primary practice location
275 Grass Valley Hwy
Auburn, CA 95603-4533
Mailing address
275 Grass Valley Hwy
Auburn, CA 95603-4533
Phone (530) 885-0344
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21390 | CA | MD | Speech/Language/Hearing Specialist/Technologist |
| PA21390 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter North Medical Foundation | Past | Accepting new patients | |
| Foot and Ankle Surgeons of Northern California | Past | Accepting new patients |
Interoperability endpoints
- amanda.welvaert.1@22193.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.
-
- Primary Care Clinic/Center
- Grass Valley, CA
- NPI 1922529031
-
- Foot & Ankle Surgery Podiatrist
- Grass Valley, CA
- NPI 1427616796
-
- Ambulatory Surgical Clinic/Center
- Yuba City, CA
- NPI 1144251521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434499200000",
"number": "1477860591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 GRASS VALLEY HWY",
"city": "AUBURN",
"state": "CA",
"postal_code": "956034533",
"telephone_number": "530-885-0344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 GRASS VALLEY HWY",
"city": "AUBURN",
"state": "CA",
"postal_code": "956034533",
"telephone_number": "530-885-0344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELVAERT",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-10",
"last_updated": "2015-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA21390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.