Amy Luckham Collar, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 18735 Issued in CA

Practice address

5720 Stoneridge Mall Rd
Suite 390,
Pleasanton, CA 94588-2828

Phone

(925) 847-5229

NPI assigned

Dec 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1841373800
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1750443909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5720 STONERIDGE MALL RD",
            "address_2": "STE. 390",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945882828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 STONERIDGE MALL RD",
            "address_2": "SUITE 390,",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945882828",
            "telephone_number": "925-847-5229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAR",
        "first_name": "AMY",
        "middle_name": "LUCKHAM",
        "name_prefix": "Ms.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 18735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3100 Dublin Blvd.",
            "city": "Dublin",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Cole, BCBA
• Leslie Ann Cole, COF
• Denise Coleman
• Stefani Coleman
• Wayne D Coleman, D.C.
• Alexa Colvin
• Comfort Senior Care LLC
• Common Compounds California
• Compassionate Home Health & Hospice Inc
• Compassionate Home Health & Hospice Inc.

• Physical Therapist in Pleasanton, CA
• Providers in Pleasanton, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.