Individual provider Active NPI

Odul Aktan Amburgey, M.D.

  • Maternal & Fetal Medicine Physician
  • San Jose, CA
National Provider Identifier
1619196466
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
C141970 Issued in CA
Practice address
2577 Samaritan Drive
Suite 705
San Jose, CA 95124-4105
Phone
(650) 404-8210
NPI assigned
Apr 24, 2007
Last updated
Jul 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X C141970 CA Primary
Maternal & Fetal Medicine Physician 207VM0101X 35.095547 OH

Addresses

Primary practice location

2577 Samaritan Drive
Suite 705
San Jose, CA 95124-4105

Mailing address

2350 W. El Camino Real
2ND Floor
Mountain View, CA 94040-2833

Other identifiers 1

IdentifierTypeStateIssuer
3090702MedicaidOH

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
I20160719002930 CA Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 3779670492 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Cincinnati College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, shared by 16 NPIs, 3,783 clinicians

Practice addresses (Care Compare)

2577 Samaritan Dr
San Jose, CA 95124-4105

370 Distel Cir
Los Altos, CA 94022-1404
Phone (650) 254-5200

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
141970CAMDMarriage & Family Therapist
C141970CAMDMaternal & Fetal Medicine Physician
35.095547OHMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jun 20, 2016 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jun 20, 2016 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jun 20, 2016 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jun 20, 2016 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jun 20, 2016 Accepting new patients
El Camino Hospital Past Accepting new patients
Ohiohealth Corporation Past Accepting new patients
Dignity Health Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients

Locations

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3120 Kearney St
Fremont, CA 94538
Phone (650) 498-3600

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

2495 Hospital Dr
Ste 400
Mountain View, CA 94040
Phone (650) 404-8210

701 E El Camino Real
#1
Mountain View, CA 94040
Phone (650) 404-8440

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 780-0110

301 Industrial Rd
#1
San Carlos, CA 94070
Phone (650) 404-8455

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

2577 Samaritan Dr
Ste 705
San Jose, CA 95124
Phone (408) 356-5292

2581 Samaritan Dr
Ste 308
San Jose, CA 95124
Phone (408) 355-1700

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: oamburgey342679@hisp.ehr.sutterhealth.org

Organizations & group practices 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1619196466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W. EL CAMINO REAL",
            "address_2": "2ND FLOOR",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 SAMARITAN DRIVE",
            "address_2": "SUITE 705",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244105",
            "telephone_number": "650-404-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBURGEY",
        "first_name": "ODUL",
        "middle_name": "AKTAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "CA",
            "license": "C141970",
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "OH",
            "license": "35.095547",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3090702",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.