NPIMap

Individual provider Active NPI

Amy Nicole McKenney, D.O.

  • Hospitalist Physician
  • Santa Monica, CA
National Provider Identifier
1689239410
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
20A19715 Issued in CA
Practice address
1250 16TH St
Santa Monica, CA 90404-1249
Phone
(310) 319-4698
Fax
(310) 319-4908
NPI assigned
May 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 010348 AZ
Internal Medicine Physician 207R00000X 19715 CA
Hospitalist Physician 208M00000X 20A19715 CA Primary

Addresses

Primary practice location

1250 16TH St
Santa Monica, CA 90404-1249

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

SBCH, Medical Education
400 W Pueblo Street
Santa Barbara, CA 93015
Phone (805) 569-7315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20230811002704 AZ Practitioner - Hospitalist 3971982323 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leading Healthcare PLLCGroup PAC ID 1850652496, 42 clinicians

Practice addresses (Care Compare)

19829 N 27TH Ave
Phoenix, AZ 85027-4001
Phone (623) 879-6100

22922 N 40TH PL
Phoenix, AZ 85050-8742
Phone (347) 309-3320

33400 N 32ND Ave
Phoenix, AZ 85085-8876
Phone (623) 580-5800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19715CAMDChiropractor
010348AZMDHospitalist Physician
20A19715CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity - Arizona Hospitalists PC Internal Medicine Current Accepting new patients
Vituity - Arizona Hospitalists PC Hospitalist CurrentSince Aug 1, 2023 Accepting new patients
Leading Healthcare, LLC Hospitalist CurrentSince Sep 1, 2024 Accepting new patients
UCLA Medical Group Internal Medicine Past Accepting new patients
Honorhealth Past Accepting new patients
Reunion Rehabilitation Hospital Peoria, LLC Past Accepting new patients
Exalt Health Rehabilitation Hospital Scottsdale LLC Past Accepting new patients

Locations

13575 W McDowell Rd
Goodyear, AZ 85395
Phone (347) 309-3320

19829 N 27th Ave
Phoenix, AZ 85027
Phone (602) 879-5720

33400 N 32nd Ave
Phoenix, AZ 85085
Phone (540) 998-0000

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1689239410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 16TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041249",
            "telephone_number": "310-319-4698",
            "fax_number": "310-319-4908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "SBCH, Medical Education",
            "address_2": "400 W Pueblo Street",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "93015",
            "country_code": "US",
            "telephone_number": "805-569-7315",
            "fax_number": "805-569-8358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENNEY",
        "first_name": "AMY",
        "middle_name": "NICOLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "010348",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "19715",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "20A19715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.