Individual provider Active NPI

Amanda Rachel De Four, M.D.

  • Internal Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1700101383
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A118058 Issued in CA
Practice address
435 H St
CV 31
Chula Vista, CA 91910-4307
Phone
(619) 691-7000
NPI assigned
Apr 7, 2010
Last updated
Jul 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X A118058 CA Primary

Addresses

Primary practice location

435 H St
CV 31
Chula Vista, CA 91910-4307

Mailing address

435 H St
CV 31
Chula Vista, CA 91910-4307
Phone (850) 712-1627

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140113001288 CA Practitioner - HospitalistPractitioner - Internal Medicine 5496983793 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
University of Florida College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps Health Inpatient Providers Medical Group IncGroup PAC ID 9436314762, 209 clinicians

Practice addresses (Care Compare)

435 H St
Chula Vista, CA 91910-4307
Phone (619) 691-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A118058CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Internal Medicine Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Apr 11, 2018 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Inpatient Providers Medical Group Inc. CurrentSince Nov 12, 2013 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Internal Medicine CurrentSince Apr 11, 2018 Accepting new patients
Scripps Health Past Accepting new patients

Locations

435 H St
Chula Vista, CA 91910
Phone (619) 691-7000

435 H St
#31
Chula Vista, CA 91910
Phone (619) 691-7000

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10140 Campus Point Dr
San Diego, CA 92121
Phone (858) 678-7050

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

Interoperability endpoints

  • Direct secure messaging: adefour13550@scrippshlth.medalliesdirect.net

Organizations & group practices 8

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 1

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": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1700101383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 H ST",
            "address_2": "CV 31",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104307",
            "telephone_number": "850-712-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 H ST",
            "address_2": "CV 31",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104307",
            "telephone_number": "619-691-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE FOUR",
        "first_name": "AMANDA",
        "middle_name": "RACHEL",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-07",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A118058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.