Individual provider Active NPI

Amy Elizabeth Olin, M.D.

  • Emergency Medicine Physician
  • San Luis Obispo, CA
National Provider Identifier
1831221480
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
96656 Issued in CA
Practice address
1911 Johnson Ave
San Luis Obispo, CA 93401-4131
Phone
(805) 543-5353
Fax
(805) 543-5708
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 96656 CA Primary

Addresses

Primary practice location

1911 Johnson Ave
San Luis Obispo, CA 93401-4131

Mailing address

655 Serrano Dr
San Luis Obispo, CA 93405-1759
Phone (760) 885-1903

Other names 1

  • Amy Elizabeth Jenkinson Former name

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
I20080115000201 CA Practitioner - Emergency Medicine 4486735552 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, Geffen School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, shared by 2 NPIs, 1,278 clinicians

Practice addresses (Care Compare)

1600 N Rose Ave
Oxnard, CA 93030-3722
Phone (805) 988-2500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
96656CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America- California Emergency Medicine CurrentSince Oct 15, 2019 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince May 1, 2010 Accepting new patients
Six Rivers Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655

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

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

1441 Constitution Blvd
Salinas, CA 93906
Phone (831) 261-8090

Organizations & group practices 5

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1831221480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 SERRANO DR",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051759",
            "telephone_number": "760-885-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014131",
            "telephone_number": "805-543-5353",
            "fax_number": "805-543-5708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIN",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "96656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "JENKINSON",
            "middle_name": "ELIZABETH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.