Active NPI
Amanda Cooper
- Pediatrics Physician
- Oakland, CA
National Provider Identifier
1790474773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A199942
- Practice address
- 3600 Broadway
Oakland, CA 94611-5730 - Phone
- (510) 752-1000
- NPI assigned
- May 4, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A199942 | CA | Primary |
Addresses
Primary practice location
3600 Broadway
Oakland, CA 94611-5730
Mailing address
3600 Broadway
Oakland, CA 94611-5730
Phone (510) 752-1000
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240730003970 | CA | Order and Referring Only - Pediatric Medicine | 8820535529 |
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- University of Utah School of Medicine, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5820 Owens Dr BLDG E 2ND Floor
Pleasanton, CA 94588-3900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A199942 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761004800000",
"number": "1790474773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 BROADWAY",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115730",
"telephone_number": "510-752-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 BROADWAY",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115730",
"telephone_number": "510-752-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-04",
"last_updated": "2025-10-21",
"certification_date": "2025-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A199942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.