Individual provider Active NPI

Amberlee Montarella, NURSE PRACTITIONER F

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1912300344
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
352981 Issued in NY
Practice address
30 Broad St FL 45
New York, NY 10004-2942
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Sep 30, 2014
Last updated
Mar 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1125752 TX
Family Nurse Practitioner 363LF0000X 95001403 CA
Nurse Practitioner 363L00000X 352981 NY Primary

Addresses

Primary practice location

30 Broad St FL 45
New York, NY 10004-2942

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

8329 Brimhall Road
Suite 804
Bakersfield, CA 93312
Phone (661) 431-1555

Other names 1

  • Amberlee Livesey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160621002561 CA Practitioner - Nurse Practitioner 5496063323 Reassigns benefits to 2 organizations
I20240213000906 GA Practitioner - Nurse Practitioner 5496063323 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
352981NYMDNurse Practitioner
1125752TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical Nurse Practitioner CurrentSince Jan 8, 2024 Accepting new patients
Amcare Medical Group, Inc. CurrentSince Aug 1, 2022 Accepting new patients
West Side Health Care District CurrentSince Apr 26, 2016 Accepting new patients

Locations

1900 Mowry Ave
Ste 301
Fremont, CA 94538
Phone (510) 619-9686

27206 Calaroga Ave
Ste 210
Hayward, CA 94545
Phone (510) 619-9686

100 E North St
Taft, CA 93268
Phone (661) 765-1935

119 Adkisson Way
Taft, CA 93268
Phone (661) 765-7234

7300 Lester Rd
Union City, GA 30291
Phone (770) 703-2604

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14270/brand/1/csg/1/fhir/r4

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": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1912300344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BROAD ST FL 45",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042942",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8329 Brimhall Road",
            "address_2": "Suite 804",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "93312",
            "country_code": "US",
            "telephone_number": "661-431-1555",
            "fax_number": "661-633-3944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTARELLA",
        "first_name": "AMBERLEE",
        "credential": "NURSE PRACTITIONER F",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-30",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1125752",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001403",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "352981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBERLEE",
            "last_name": "LIVESEY",
            "credential": "NURSE PRACTITIONER F",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.