Individual provider Active NPI

Amy Koplovsky, MD

  • Emergency Medicine Physician
  • Lynwood, CA
National Provider Identifier
1578519963
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A55455 Issued in CA
Practice address
3630 E Imperial Hwy
Lynwood, CA 90262-2609
Phone
(310) 900-8900
NPI assigned
May 26, 2006
Last updated
Nov 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A55455 CA Primary

Addresses

Primary practice location

3630 E Imperial Hwy
Lynwood, CA 90262-2609

Mailing address

PO Box 2705-605
Huntington Beach, CA 92647
Phone (562) 809-3571

Other identifiers 1

IdentifierTypeStateIssuer
00A554550MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
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

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040131000296 CA Practitioner - Emergency MedicinePractitioner - Endocrinology 4385547728 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A55455CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Dec 15, 2014 Accepting new patients
County of Los Angeles CurrentSince Jan 1, 2004 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 15, 2014 Accepting new patients
Nes Western Group, a Professional Corporation Emergency Medicine CurrentSince Feb 11, 2024 Accepting new patients
Nes Western Group, a Professional Corporation Emergency Medicine CurrentSince Feb 11, 2024 Accepting new patients
Team Physicians of Northern California Medical Group Inc Emergency Medicine CurrentSince May 13, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
County of Los Angeles CurrentSince Jan 1, 2004 Accepting new patients
Hollywood Presbyterian Emergency Medical Associates, Inc. Emergency Medicine CurrentSince Sep 25, 2024 Accepting new patients
Downey Acute Care Medical Group Emergency Medicine Past Accepting new patients
Front Line Emergency Care Spec Emergency Medicine Past Accepting new patients
California Em-I Medical Services, a Medical Corporation Emergency Medicine Past Accepting new patients
Phalarope Inpatient Services, a Medical Corporation Past Accepting new patients
Columbia Emergency Medical Group Inc Emergency Medicine Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3184

1900 Sullivan Ave
Daly City, CA 94015
Phone (650) 991-6503

9333 Imperial Hwy
Downey, CA 90242
Phone (562) 657-8850

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

1300 N Vermont Ave
Los Angeles, CA 90027
Phone (213) 413-3000

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

7300 Medical Ctr
West Hills, CA 91307
Phone (818) 612-8301

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1578519963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2705-605",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92647",
            "telephone_number": "562-809-3571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 E IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622609",
            "telephone_number": "310-900-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPLOVSKY",
        "first_name": "AMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A55455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A554550",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9333 Imperial Hwy",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.