Albert Nana Amoani Jr., PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA18280 Issued in CA

Practice address

38600 Medical Center Dr
Palmdale, CA 93551-4483

Phone

(661) 382-6000

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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.

• Cep America - California

  • Emergency Medicine Physician
  • Santa Ana, CA
  • NPI 1548667843

  CA

  Medicare reassignment
• Em Alliance California, Apc

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1376305755

  CA

  Medicare reassignment
• High Desert Medical Group

  • Multi-Specialty Clinic/Center
  • Lancaster, CA
  • NPI 1720196702

  CA

  Medicare reassignment
• Hollywood Presbyterian Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • Los Angeles, CA
  • NPI 1972826931

  CA

  Medicare reassignment
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834

  CA

  Medicare reassignment
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280

  CA

  Medicare reassignment
• Cep America - California

  • Emergency Medicine Physician
  • Pomona, CA
  • NPI 1740235258
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1316463763
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Lancaster, CA
  • NPI 1982863783
  NPD
• Centinela Freeman Emergency Medical Associates

  • Emergency Medicine Physician
  • Inglewood, CA
  • NPI 1962539684
  NPD (past)

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

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 5, 2024.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1689613515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1646",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917291646",
            "telephone_number": "310-433-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38600 MEDICAL CENTER DR",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514483",
            "telephone_number": "661-382-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMOANI",
        "first_name": "ALBERT",
        "middle_name": "NANA",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• American Dental Center of Palmdale
• American Health Services LLC
• Olga B Amiel, FNP-BC
• Minoo Taraz Amini, MS, LMFT, NCC
• Adam Amir, D.O.
• Anas Entabi M.D., Inc
• Anaverdes Villa, Inc
• Andalib Chiropractic Inc
• Nikta Andalib, D.C.
• Carmela Kay Andersen-Noel, MA, LMFT

• All providers in Palmdale, CA
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.