Amanda Jo Nelson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

51860 Issued in CA

Practice address

3516 Elm Ave Apt 408
Long Beach, CA 90807-3916

Phone

(310) 514-6525

NPI assigned

Aug 26, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Harbor Psychiatry and Mental Health Professional CorporationGroup PAC ID 8729394572, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Harbor Psychiatry & Mental Health, Professional Corporation

  • Psychiatry Physician
  • Newport Beach, CA
  • NPI 1780050054
  Medicare reassignment Care Compare group
• Julia Evans PHD Psychology PC

  • Clinical Psychologist
  • Costa Mesa, CA
  • NPI 1861902280
  Medicare reassignment
• Mountain View Urgent Care Group, Inc

  • Emergency Medicine Physician
  • Fontana, CA
  • NPI 1023306784
  Medicare reassignment
• Mountain View Urgent Care Group, Inc

  • Emergency Medicine Physician
  • Pomona, CA
  • NPI 1801233036
  NPD

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1932509072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3516 ELM AVE APT 408",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3516 ELM AVE APT 408",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073916",
            "telephone_number": "310-514-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria L. Negriete-Bleazard, RDA
• Neighborhood Pediatrics Urgent Care PC
• Neil Hersh, M.D., a Professional Corporation
• Nazanin Nancy Nekonejad, PHARM D
• Nellie Grace Bell, Ma, Inc.
• Bo Nelson
• Brittany Nelson
• Bryan Nelson
• Isabelle Nelson
• Linda Anne Nelson

• Physician Assistant in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; 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.