Individual provider Active NPI

Amanda Marie Lopez, FNP-BC

  • Family Nurse Practitioner
  • Elk Grove, CA
National Provider Identifier
1730955857
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95028171 Issued in CA
Practice address
9093 Elk Grove Blvd Ste 100
Elk Grove, CA 95624-2047
Phone
(916) 937-3094
NPI assigned
Nov 29, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2025

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 95028171 CA Primary

Addresses

Primary practice location

9093 Elk Grove Blvd Ste 100
Elk Grove, CA 95624-2047

Mailing address

9727 Elk Grove Florin Rd Ste 120
Elk Grove, CA 95624-2291
Phone (575) 635-0935

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alleviant HealthGroup PAC ID 8325544604, 3 clinicians

Practice addresses (Care Compare)

257 S Lincoln Way
Galt, CA 95632-1711
Phone (209) 919-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95028171CAMDFamily Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1730955857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9727 ELK GROVE FLORIN RD STE 120",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956242291",
            "telephone_number": "575-635-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9093 ELK GROVE BLVD STE 100",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956242047",
            "telephone_number": "916-937-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-29",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.