Peninsula Ambulatory Medical Services PC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

PENINSULA AMBULATORY MEDICAL SERVICES PC

Practice address

100 S Ellsworth Ave Ste 504
San Mateo, CA 94401-3929

Phone

(650) 507-3348

NPI assigned

Nov 13, 2024

Organization subpart

No

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

Authorized official

Name

Andrew Vargas, MDNPI 1932594793

Title

President

Phone

(404) 502-5594

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrew Layne Vargas, MD

  • Pain Medicine (Anesthesiology) Physician
  • Emeryville, CA
  • NPI 1932594793
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1487478749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 MARKET ST # 238189",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941045401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S ELLSWORTH AVE STE 504",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013929",
            "telephone_number": "650-507-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA AMBULATORY MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "VARGAS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-502-5594",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystle Tashanty C Pena
• Naomi Pena
• Savannah Pena
• Maria Consuelo Pendse
• Sarah C Penegor, RN
• Peninsula Endoscopy Center LLC (Mid Peninsula Endoscopy Center)
• Peninsula Eye Physicians Medical Group,Inc.
• Peninsula Family YMCA
• Peninsula Foot & Ankle Center Corp
• Peninsula Gastrointestinal

• Pain Clinic/Center in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Pain Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.