Individual provider Active NPI

Amruta Gill, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fremont, CA
National Provider Identifier
1487486395
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95028152 Issued in CA
Practice address
39159 Paseo Padre Pkwy Ste 121
Fremont, CA 94538-1600
Phone
(510) 952-1190
NPI assigned
Aug 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95221977 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95028152 CA Primary

Addresses

Primary practice location

39159 Paseo Padre Pkwy Ste 121
Fremont, CA 94538-1600

Mailing address

39159 Paseo Padre Pkwy Ste 121
Fremont, CA 94538-1600
Phone (510) 952-1190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

39159 Paseo Padre Pkwy
Suite 121
Fremont, CA 94538-1600

6910 Delco Ave
Winnetka, CA 91306-3514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95221977CAMDRegistered Nurse
95028152CAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1487486395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39159 PASEO PADRE PKWY STE 121",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381600",
            "telephone_number": "510-952-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39159 PASEO PADRE PKWY STE 121",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381600",
            "telephone_number": "510-952-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "AMRUTA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95221977",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95028152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.