NPIMap

Individual provider Active NPI

Amanda May Pacillas

  • Family Nurse Practitioner
  • Visalia, CA
National Provider Identifier
1700409943
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F05200132 Issued in CA
Practice address
1136 N Chinowth St
Visalia, CA 93291-4113
Phone
(559) 671-0101
Fax
(559) 671-0101
NPI assigned
May 21, 2020
Last updated
May 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F05200132 CA Primary

Addresses

Primary practice location

1136 N Chinowth St
Visalia, CA 93291-4113

Mailing address

2643 N Chinowth St
Visalia, CA 93291-8077
Phone (559) 737-1231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210323001380 CA Practitioner - Nurse Practitioner 4688081482 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Assoc Medical Clinic IncGroup PAC ID 2769395375, 10 clinicians

Practice addresses (Care Compare)

820 S Akers St
Suite 220
Visalia, CA 93277-8307
Phone (559) 733-3346

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F05200132CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Core Physical Therapy by Bryan Pacillas PC CurrentSince May 24, 2020 Accepting new patients
Innovative Dermatology Alliance Ca CurrentSince Mar 15, 2021 Accepting new patients
Kaweah Delta Health Care District CurrentSince Sep 14, 2021 Accepting new patients
Kaweah Delta Health Care District CurrentSince Sep 14, 2021 Accepting new patients
Orthopaedic Assoc Medical Clinic, Inc. CurrentSince Jul 23, 2023 Accepting new patients
Kaweah Delta Health Care District Current Accepting new patients
Seth Criner, D.O., M.S., Inc. PastSince Aug 15, 2016 Accepting new patients
Hanford Community Hospital Past Accepting new patients
Kaweah Delta Health Care District Past Accepting new patients
Sierra View Local Health Care District Past Accepting new patients

Locations

13921 W Grand Ave
Bldg E
Surprise, AZ 85374
Phone (623) 212-1121

1136 N Chinowth St
Visalia, CA 93291
Phone (559) 671-0101

1633 S Court St
Visalia, CA 93277
Phone (559) 624-6090

3600 W Flagstaff Ave
Visalia, CA 93291
Phone (559) 624-6090

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

5530 Avenida de los Robles
Visalia, CA 93291
Phone (559) 733-5050

820 S Akers St
Ste 220
Visalia, CA 93277
Phone (559) 625-0551

Organizations & group practices 10

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 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": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1700409943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2643 N CHINOWTH ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932918077",
            "telephone_number": "559-737-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 N CHINOWTH ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932914113",
            "telephone_number": "559-671-0101",
            "fax_number": "559-671-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACILLAS",
        "first_name": "AMANDA",
        "middle_name": "MAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-21",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F05200132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.