Individual provider Active NPI

Amie Llerena Jimenez, M.D.

  • Emergency Medicine Physician
  • El Paso, TX
National Provider Identifier
1720267495
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A110037 Issued in CA
Practice address
4800 Alberta Ave
Dept. of Emergency Medicine
El Paso, TX 79905-2709
Phone
(915) 545-7330
NPI assigned
Oct 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X BP10021595 TX
Emergency Medicine Physician 207P00000X A110037 CA Primary

Addresses

Primary practice location

4800 Alberta Ave
Dept. of Emergency Medicine
El Paso, TX 79905-2709

Mailing address

1060 Marcine St
La Habra, CA 90631-3325
Phone (562) 209-2643

Other identifiers 1

IdentifierTypeStateIssuer
1720267495MedicaidCA

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
I20100629000699 CA Practitioner - Emergency Medicine 8224106117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, Geffen School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

1911 Johnson Ave
San Luis Obispo, CA 93401-4131
Phone (805) 543-5353

Hospital & facility affiliations

  • Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107
  • French Hospital Medical Center Hospital, San Luis Obispo, CA, CCN 050232

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10021595TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California Emergency Medicine CurrentSince Jan 1, 2011 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jan 1, 2011 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Az Corridor Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

345 S Halcyon Rd
Arroyo Grande, CA 93420
Phone (805) 489-4261

751 Medical Center Ct
#1182
Chula Vista, CA 91911

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

12601 Garden Grove Blvd
Garden Grove, CA 92843
Phone (714) 537-5160

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

1400 E Church St
Santa Maria, CA 93454
Phone (805) 739-3000

1911 Johnson Ave
Sn Luis Obisp, CA 93401
Phone (805) 542-6633

Organizations & group practices 4

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 2

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": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1720267495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 MARCINE ST",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906313325",
            "telephone_number": "562-209-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 ALBERTA AVE",
            "address_2": "DEPT. OF EMERGENCY MEDICINE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052709",
            "telephone_number": "915-545-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "AMIE",
        "middle_name": "LLERENA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "BP10021595",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A110037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720267495",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.