Individual provider Active NPI

Amanda J Ball, FNP

  • Primary Care Nurse Practitioner
  • Newbury Park, CA
National Provider Identifier
1891419073
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
729955 Issued in CA
Practice address
3184 Lynn CT
Newbury Park, CA 91320-3029
Phone
(520) 465-7277
NPI assigned
Sep 30, 2022
Last updated
Sep 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 729955 CA Primary

Addresses

Primary practice location

3184 Lynn CT
Newbury Park, CA 91320-3029

Mailing address

3184 Lynn CT
Newbury Park, CA 91320-3029
Phone (520) 465-7277

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230106002203 CA Practitioner - Nurse Practitioner 6103296124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jeffrey E Galpin MD IncGroup PAC ID 5193753077, 2 clinicians

Practice addresses (Care Compare)

5525 Etiwanda Ave
Suite 308
Tarzana, CA 91356-6124
Phone (818) 344-6111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
729955CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Primary Care of California PC Single Specialty CurrentSince May 9, 2024 Accepting new patients

Locations

806 New Los Angeles Ave
Ste A
Moorpark, CA 93021
Phone (805) 334-8650

4550 Van Nuys Blvd
Ste A4
Sherman Oaks, CA 91403
Phone (818) 230-2938

2944 Tapo Canyon Rd
Ste A
Simi Valley, CA 93063
Phone (805) 306-5990

21835 Ventura Blvd
Ste 21837
Woodland Hills, CA 91364
Phone (818) 600-7348

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1891419073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3184 LYNN CT",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913203029",
            "telephone_number": "520-465-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3184 LYNN CT",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913203029",
            "telephone_number": "520-465-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALL",
        "first_name": "AMANDA",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-30",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "729955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newbury Park, CA

Sources for this page

Verify at the official NPI Registry.