Charles Agustin Amador, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

51709 Issued in CA

Practice address

2019 N Lake Mead Cir
Orange, CA 92867-2471

Phone

(714) 244-9134

NPI assigned

Jun 23, 2014

Last updated

Feb 5, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Hollywood Presbyterian Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • Los Angeles, CA
  • NPI 1972826931
  Medicare reassignment
• Providence Facey Medical Foundation

  dba Facey Medical Group

  • Internal Medicine Physician
  • Valencia, CA
  • NPI 1710031588
  Medicare reassignment
• Ridgeline Emergency Physicians Medical Group, Inc.

  • Emergency Medicine Physician
  • Northridge, CA
  • NPI 1972953230
  Medicare reassignment
• Sherman Oaks Emergency Medical Associates

  • Emergency Medicine Physician
  • Sherman Oaks, CA
  • NPI 1518904150
  Medicare reassignment
• Tarzana Emergency Medical Associates

  • Emergency Medicine Physician
  • Tarzana, CA
  • NPI 1235176702
  Medicare reassignment
• Valley Presbyterian Emergency Medical Associates

  • Emergency Medicine Physician
  • Van Nuys, CA
  • NPI 1033133103
  Medicare reassignment
• Providence Facey Medical Foundation

  dba Providence Express Care

  • Multi-Specialty Clinic/Center
  • Irvine, CA
  • NPI 1891348447
  NPD

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1659786242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4126 NORMAL AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928672471",
            "telephone_number": "714-244-9134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 N LAKE MEAD CIR",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928672471",
            "telephone_number": "714-244-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMADOR",
        "first_name": "CHARLES",
        "middle_name": "AGUSTIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amarissa Alvizo
• Dareen Alwan, MD
• Al Said Aly, MD
• Ahmed Nasir Mohamed Alsuwa Alzaabi, M.D
• Mykeisha Alzaatra, PA-C
• Elyzabeth Grace Amador, MD
• Philip Amante
• Amar Therapy, Inc.
• Leahneth Amaya
• Savanah Jemayn Amaya

• Physician Assistant in Orange, CA
• Providers in Orange, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.