Organization Active NPI

Ams Mobile Health Diagnostics

  • Vascular Sonography Radiologic Technologist
  • San Mateo, CA
National Provider Identifier
1770001992
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Sonography Radiologic TechnologistTaxonomy code 2471V0105X
Legal business name
AMS MOBILE HEALTH DIAGNOSTICS
Practice address
1646 Sugarloaf Dr
San Mateo, CA 94403-3946
Phone
(415) 756-9700
Fax
(888) 807-9131
NPI assigned
Sep 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Authorized official

Name
Dmitry Melnikov
Title
President
Phone
(415) 756-9700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Sonography Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471V0105X Primary

Addresses

Primary practice location

1646 Sugarloaf Dr
San Mateo, CA 94403-3946

Mailing address

1646 Sugarloaf Dr
San Mateo, CA 94403-3946
Phone (415) 756-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171023000681 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3274809033 Practice locations: South San Francisco, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1770001992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1646 SUGARLOAF DR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944033946",
            "telephone_number": "415-756-9700",
            "fax_number": "888-807-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1646 SUGARLOAF DR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944033946",
            "telephone_number": "415-756-9700",
            "fax_number": "888-807-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMS MOBILE HEALTH DIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-08",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "MELNIKOV",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-756-9700"
    },
    "taxonomies": [
        {
            "code": "2471V0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.