Amanda Williams Gumbert, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA18153 Issued in CA

Practice address

6645 Alvarado Rd
Suite# 4000
San Diego, CA 92120-5208

Phone

(619) 810-1010

Fax

(619) 810-1011

NPI assigned

Jun 29, 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

Other identifiers 1

Other names 1

• Miss Amanda Kristine Williams Former name

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

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: agumbert42675@scrippshlth.medalliesdirect.net

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.

• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment
• La Jolla Neurosurgical Associates a Medical Corporation

  • Specialist
  • La Jolla, CA
  • NPI 1073654604
  Medicare reassignment
• Pac Neuro Inc

  • Neurological Surgery Physician
  • San Diego, CA
  • NPI 1700821915
  Medicare reassignment
• San Diego Neurotrauma Associates Inc

  • Neurological Surgery Physician
  • San Diego, CA
  • NPI 1780822213
  Medicare reassignment
• Senta Clinic, Inc

  • Neurological Surgery Physician
  • San Diego, CA
  • NPI 1508068016
  Medicare reassignment
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1891723870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6645 ALVARADO RD",
            "address_2": "SUITE# 4000",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205208",
            "telephone_number": "619-810-1010",
            "fax_number": "619-810-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6645 ALVARADO RD",
            "address_2": "SUITE# 4000",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205208",
            "telephone_number": "619-810-1010",
            "fax_number": "619-810-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMBERT",
        "first_name": "AMANDA",
        "middle_name": "WILLIAMS",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA18153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA18153",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WILLIAMS",
            "middle_name": "KRISTINE",
            "prefix": "MISS",
            "credential": "P.A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victoria Rose Gulotta, NP
• Chloe Gulyas
• Tyler Gulyas, LPCC
• Caitlyn Bailey Gumaer, PHD, BCBA
• Sara Rose Gumataotao
• Hana Gumbus
• Michelle Gumin
• Sophia Marie Gumina
• Lindsay Gumm, LCSW
• Jennifer Kay Bahr Gunderman, N.D.

• Surgical Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.

Verify at the official NPI Registry.