Ira Vergara Amayun, BSN, MPH, DNP, FNP-C
Individual provider Active NPI Nurse Practitioner · Fremont, CA
NPI 1639845993 · NPPES record last updated Oct 16, 2023
Key facts
- NPI
- 1639845993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 95018990 (CA)
- Practice address
- 39141 Civic Center Dr Ste 130
Fremont, CA 94538-5831 - Phone
- (510) 248-1680
- NPI assigned
- Aug 18, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 21
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- County of San Mateo
Washington Township Medical Foundation
Practice addresses (Care Compare)
380 90TH St
Daly City, CA 94015-1807
Phone (650) 573-2222
39141 Civic Ctr Dr
Suite 130
Fremont, CA 94538-5831
Phone (510) 791-1005
Hospital & facility affiliations
- San Mateo Medical Center
- Washington Hospital
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220716000389 | CA | Practitioner - Nurse Practitioner | 8729469127 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor on Science - Nursing, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of San Mateo | Current |
Accepting new patients | |
| Washington Township Medical Foundation | Current |
Accepting new patients | |
| County of San Mateo | Current |
Accepting new patients | |
| San Benito Health Foundation | Current |
Accepting new patients | |
| Washington Township Medical Foundation | Current |
Accepting new patients | |
| Sutter Bay Medical Foundation | Current | Accepting new patients | |
| Washington Township Medical Group | Past | Accepting new patients |
Locations
18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590
1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100
3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800
39141 Civic Center Dr
Ste 130
Fremont, CA 94538
Phone (510) 248-1680
39500 Fremont Blvd
Ste 100
Fremont, CA 94538
Phone (510) 248-1800
1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777
351 Felice Dr
Hollister, CA 95023
Phone (831) 637-5306
325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977
370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200
600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755
101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200
795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832
1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911
151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505
3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847
685 Coleman Ave
Ste 20
San Jose, CA 95110
Phone (408) 217-6404
222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222
123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200
3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750
10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488
33077 Alvarado Niles Rd
Union City, CA 94587
Phone (510) 248-1500
550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865
Interoperability endpoints
- iamayun148472@direct.whhs.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95018990 | CA | Yes |
Addresses
Primary practice location
39141 Civic Center Dr Ste 130
Fremont, CA 94538-5831
Mailing address
2080 Sarasota Ave
San Jose, CA 95122-2371
Other providers in Fremont, CA
- Mary M. Alyono
- Alzheimer'S Services of the East Bay, Incorporated
- Sheida Jalili Amadeh
- Jose Jorge Amador
- Joshua Evan Amano
- American Current Care of California
- Marcela Cristina Amezcua
- Nivek Amin
- Banafsha Amiri
- Sabrina Amiri
All providers in Fremont, CA · Nurse Practitioner 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 16, 2023. 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.