Amanda Lois Macallister, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA18521 Issued in CA

Practice address

8265 W Sunset Blvd Ste 207
West Hollywood, CA 90046-2470

Phone

(323) 375-0950

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Interoperability endpoints

• Direct secure messaging: amandamacallister@clchc.allscriptsdirect.net

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

• Celebrating Life Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Mission Viejo, CA
  • NPI 1386273100
  Medicare reassignment
• Celebrating Life Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Irvine, CA
  • NPI 1558068098
  NPD

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597536000000",
    "number": "1669533170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 E 17TH ST.",
            "address_2": "N152",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012215",
            "telephone_number": "714-285-1100",
            "fax_number": "714-285-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8265 W SUNSET BLVD STE 207",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900462470",
            "telephone_number": "323-375-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 E 17th St",
            "address_2": "N152",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927012201",
            "country_code": "US",
            "telephone_number": "714-285-1100",
            "fax_number": "714-285-1323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACALLISTER",
        "first_name": "AMANDA",
        "middle_name": "LOIS",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-16",
        "certification_date": "2020-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA18521",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirk James Lynch, PHARMD
• Lyudmila Gutgarts, D.D.S., Eliozar Gutgarts, D.D.S., Apc
• Jacklyn C Ma, M.D.
• Jun Ho Ma
• Wenli Ma, MD
• Allan George Macdonald, OTR/L
• Yaniv Maddahi, MD
• Judy C Maddox, DO
• Madrid Home Health Agency, LLC
• Elinora S Madrid-Carranza, M.D.

• Physician Assistant in West Hollywood, CA
• Providers in West Hollywood, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2020; 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.