Individual provider Active NPI

Amy Wan-Ju Kao, M.D.

  • Diagnostic Radiology Physician
  • San Bruno, CA
National Provider Identifier
1891968384
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A112376 Issued in CA
Practice address
1001 Sneath LN Ste 310
San Bruno, CA 94066-2349
Phone
(650) 615-6051
Fax
(650) 615-6066
NPI assigned
Apr 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A112376 CA Primary

Addresses

Primary practice location

1001 Sneath LN Ste 310
San Bruno, CA 94066-2349

Mailing address

1001 Sneath LN Ste 310
San Bruno, CA 94066-2349
Phone (650) 615-6051

Other practice location 1

13813 Metro Pkwy
Fort Myers, FL 33912-4343
Phone (855) 674-4624 ext. 44624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NC, FL, OH, TX, OK6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20100825000899 CA Practitioner - Diagnostic RadiologyPractitioner - Internal Medicine 3971627142 Reassigns benefits to 1 organization
I20250929000764 NC Practitioner - Diagnostic Radiology 3971627142 Reassigns benefits to 1 organization
I20251022005100 FL Practitioner - Diagnostic Radiology 3971627142 Reassigns benefits to 1 organization
I20251104003366 OH Practitioner - Diagnostic Radiology 3971627142 Reassigns benefits to 1 organization
I20260211003288 TX Practitioner - Diagnostic Radiology 3971627142 Reassigns benefits to 10 organizations
I20260217003867 OK Practitioner - Diagnostic Radiology 3971627142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Ohio State University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choctaw Nation of Oklahoma 271 clinicians
Cherokee Nation 446 clinicians
Pawnee Indian Health Center 88 clinicians
Wilmington Health PLLC 364 clinicians
Millennium Physician Group LLC 976 clinicians
Lawton Indian Hospital 126 clinicians
Creek Nation Hospital and Clinics 364 clinicians
El Reno Indian Health Center 52 clinicians
Beacon Orthopaedics and Sports Medicine LTD 471 clinicians
Diagnostic Imaging Associates Inc 88 clinicians

Practice addresses (Care Compare)

1 Choctaw Way
Talihina, OK 74571-2022
Phone (539) 316-6391

100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3100

101 S Moore Ave
Claremore, OK 74017-5047
Phone (539) 234-1000

1201 Heritage Cir
Pawnee, OK 74058-3744
Phone (918) 762-2517

1202 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

13813 Metro Pkwy
Fort Myers, FL 33912-4343
Phone (239) 936-1343

1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002
Phone (580) 354-5000

1800 E Coplin St
Creek Nation Community Hospital
Okemah, OK 74859-4642
Phone (918) 623-1424

1801 Chukka Hina
Durant, OK 74701-7117
Phone (539) 316-6391

1801 Parkview Dr
El Reno, OK 73036-2103
Phone (405) 234-5600

5060 Bradenton Ave
Suite B
Dublin, OH 43017-3511
Phone (614) 505-8890

710 S Golden W Ave
Arcadia, CA 91007-6449
Phone (918) 935-3550

One Choctaw Way
Talihina, OK 74571-2022

Hospital & facility affiliations

  • Saint Francis Hospital Muskogee Hospital, Muskogee, OK, CCN 370025
  • Cherokee Nation W W Hastings Indian Hospital Hospital, Tahlequah, OK, CCN 370171
  • SSM Health St Anthony Hospital - Shawnee Hospital, Shawnee, OK, CCN 370149
  • Great Plains Regional Medical Center Hospital, Elk City, OK, CCN 370019
  • Northeastern Health System Hospital, Tahlequah, OK, CCN 370089

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A112376CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington Health PLLC CurrentSince Sep 1, 2025 Accepting new patients
Millennium Physician Group LLC CurrentSince Oct 1, 2025 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Feb 1, 2026 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jan 9, 2026 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jan 9, 2026 Accepting new patients
Diagnostic Imaging Associates Inc Diagnostic Radiology CurrentSince Dec 5, 2025 Accepting new patients
Beacon Orthopaedics & Sports Medicine, LTD CurrentSince Sep 1, 2025 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Feb 1, 2026 Accepting new patients
Beacon Orthopaedics & Sports Medicine LTD CurrentSince Sep 1, 2025 Accepting new patients
Millennium Physician Group LLC CurrentSince Oct 1, 2025 Accepting new patients
Wilmington ASC LLC CurrentSince Sep 1, 2025 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

13813 Metro Pkwy
Fort Myers, FL 33912
Phone (239) 936-1343

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

6480 Harrison Ave
Cincinnati, OH 45247
Phone (513) 251-7827

311 S 15th St
Ste 205
Coshocton, OH 43812
Phone (740) 622-5060

5060 Bradenton Ave
Ste B
Dublin, OH 43017
Phone (609) 969-8562

2750 Newark Granville Rd
Granville, OH 43023
Phone (740) 788-9220

1800 E Coplin St
Okemah, OK 74859
Phone (918) 623-1424

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

Dept 1467
Tulsa, OK 74182

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

Interoperability endpoints

  • Direct secure messaging: amy.kao.p1@direct.wilmingtonhealth.nextgenshare.com
  • Direct secure messaging: amy.kao.p1@direct.beaconortho.nextgenshare.com

Organizations & group practices 52

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.

View all 52

Hospital & facility affiliations 11

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": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1891968384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SNEATH LN STE 310",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940662349",
            "telephone_number": "650-615-6051",
            "fax_number": "650-615-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SNEATH LN STE 310",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940662349",
            "telephone_number": "650-615-6051",
            "fax_number": "650-615-6066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13813 METRO PKWY",
            "address_purpose": "LOCATION",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124343",
            "country_code": "US",
            "telephone_number": "855-674-4624 x44624",
            "fax_number": "941-883-8386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAO",
        "first_name": "AMY",
        "middle_name": "WAN-JU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-07",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A112376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bruno, CA

Sources for this page

Verify at the official NPI Registry.