NPIMap

Individual provider Active NPI

Ira Vergara Amayun, BSN, MPH, DNP, FNP-C

  • Nurse Practitioner
  • Fremont, CA
National Provider Identifier
1639845993
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95018990 Issued in CA
Practice address
39141 Civic Center Dr Ste 130
Fremont, CA 94538-5831
Phone
(510) 248-1680
NPI assigned
Aug 18, 2021
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95018990 CA Primary

Addresses

Primary practice location

39141 Civic Center Dr Ste 130
Fremont, CA 94538-5831

Mailing address

2080 Sarasota Ave
San Jose, CA 95122-2371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220716000389 CA Practitioner - Nurse Practitioner 8729469127 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
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 MateoGroup PAC ID 9032023171, 316 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Current Accepting new patients
San Benito Health Foundation CurrentSince Jun 28, 2022 Accepting new patients
Washington Township Medical Foundation CurrentSince Oct 16, 2023 Accepting new patients
County of San Mateo CurrentSince May 10, 2024 Accepting new patients
Washington Township Medical Foundation CurrentSince Oct 16, 2023 Accepting new patients
County of San Mateo CurrentSince May 10, 2024 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) 634-2123

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

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

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

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

  • Direct secure messaging: iamayun148472@direct.whhs.com

Organizations & group practices 7

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1639845993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 SARASOTA AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951222371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39141 CIVIC CENTER DR STE 130",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945385831",
            "telephone_number": "510-248-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAYUN",
        "first_name": "IRA",
        "middle_name": "VERGARA",
        "credential": "BSN, MPH, DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95018990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.