Pooja Atul Amin, MD
Individual provider Active NPI Psychiatry Physician · Montclair, CA
NPI 1568081982 · NPPES record last updated Oct 15, 2024
Key facts
- NPI
- 1568081982
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- A193250 (CA)
- Practice address
- 5330 San Bernardino St
Montclair, CA 91763-2952 - Phone
- (909) 427-6112
- NPI assigned
- Apr 15, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Southern California Permanente Medical Group
Practice addresses (Care Compare)
5330 San Bernardino St
Montclair, CA 91763-2952
Phone (909) 399-3700
9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000
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: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241101000876 | CA | Practitioner - Psychiatry | 1759706021 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A193250 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients |
Locations
9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910
5330 San Bernardino St
Montclair, CA 91763
Phone (909) 399-3700
393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A193250 | CA | Yes |
Addresses
Primary practice location
5330 San Bernardino St
Montclair, CA 91763-2952
Mailing address
5330 San Bernardino St
Montclair, CA 91763-2952
Phone (909) 427-6112
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Other providers in Montclair, CA
- American Therapy House
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- Cynthia Amezquita
- Amiel R Patel DDS Inc
- Amiel R. Patel, D.D.S; Prof. Dental Corp.
- Joshua Ampuero
- Alexandria Stephanie Amsbry
- Anita Biyanca Anand
- Dominique Ancona
- Christie Anderson
All providers in Montclair, CA · Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.