Adamma Theresa Amadi, FNP
Individual provider Active NPI Primary Care Nurse Practitioner · Cerritos, CA
NPI 1487030656 · NPPES record last updated Dec 11, 2024
Key facts
- NPI
- 1487030656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 95002583 (CA)
- Practice address
- 18000 Studebaker Rd Ste 800
Cerritos, CA 90703-2671 - Phone
- (213) 628-6539
- Fax
- (213) 566-1361
- NPI assigned
- Aug 10, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220113001337 | CA | Practitioner - Nurse Practitioner | 7416246277 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95002583 | CA | MD | Family Nurse Practitioner |
| 1487030656 | CA | MD | Primary Care Nurse Practitioner |
Practice roles (7 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oakk Care Inc. | Family | Current |
Accepting new patients |
| Tri-State Community Healthcare Center | Current | Accepting new patients | |
| Lakeside Medical Organization, a Medical Group Inc. | Current |
Accepting new patients | |
| Healthcare Partners Affiliates Medical Group | Current |
Accepting new patients | |
| Tri-State Community Healthcare Center | Current |
Accepting new patients | |
| Healthcare Partners Affiliates Medical Group | Current |
Accepting new patients | |
| Tri-State Community Healthcare Center | Current |
Accepting new patients |
Locations
11888 Bartlett Ave
Adelanto, CA 92301
Phone (760) 530-9944
11499 Bartlett Ave
Adelanto, CA 92301
Phone (760) 444-4258
1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000
5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864
824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706
4137 Verdugo Rd
Los Angeles, CA 90065
Phone (323) 256-5800
14901 Rinaldi St
Ste 200201
Mission Hills, CA 91345
Phone (818) 365-8553
820 W Broadway St
Needles, CA 92363
Phone (730) 326-0222
8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000
900 N Western Ave
San Pedro, CA 90732
Phone (310) 832-4225
1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611
1500 W West Covina Pkwy
West Covina, CA 91790
Phone (626) 430-9991
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- adamma.epoh.p1@direct.lakeside.nextgenshare.com
- aepoh205435@westdirect.optum.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95002583 | CA | |
| Family Nurse Practitioner | 363LF0000X | 95002583 | CA | |
| Primary Care Nurse Practitioner | 363LP2300X | 1487030656 | CA | |
| Primary Care Nurse Practitioner | 363LP2300X | 95002583 | CA | Yes |
Addresses
Primary practice location
18000 Studebaker Rd Ste 800
Cerritos, CA 90703-2671
Mailing address
18000 Studebaker Rd Ste 700
Cerritos, CA 90703-2522
Phone (213) 628-6539
Other providers in Cerritos, CA
- Oscar Anthony Alvarado
- Maria Concepcion Alvarez Ortiz
- Alexandra Vanessa Alvarez
- Frank David Alvarez
- Hector Alvarez
- Diana Garcia Amador
- Priscilla Ngozi Amalu
- Devin Amato
- Anthony Amaya
- Esmeralda Amaya
All providers in Cerritos, CA · Primary Care Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.