Individual provider Active NPI

Amanda Amy Diep, PA-C

  • Physician Assistant
  • San Jose, CA
National Provider Identifier
1962065805
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
56841 Issued in CA
Practice address
2577 Samaritan Dr Ste 810
San Jose, CA 95124-4109
Phone
(408) 358-0133
NPI assigned
Apr 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 56841 CA Primary

Addresses

Primary practice location

2577 Samaritan Dr Ste 810
San Jose, CA 95124-4109

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (408) 358-0133

Other practice location 1

611 Abbott St Ste 101
Salinas, CA 93901-4391
Phone (831) 757-3041

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
I20190711001076 CA Practitioner - Physician Assistant 6608101779 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

2425 Samaritan Dr
San Jose, CA 95124-3908
Phone (408) 559-2011

2506 Samaritan CT
San Jose, CA 95124-4001
Phone (408) 739-6000

370 Distel Cir
Los Altos, CA 94022-1404
Phone (650) 254-5200

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

815 Pollard Rd
Los Gatos, CA 95032-1438
Phone (408) 378-6131

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
56841CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Nov 1, 2020 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Nov 1, 2020 Accepting new patients
Svmhs Clinics CurrentSince Jul 15, 2019 Accepting new patients
El Camino Hospital Past Accepting new patients
El Camino Health Medical Group Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Lancelot O Alexander MD a Medical Corporation Past Accepting new patients
El Camino Hospital Past Accepting new patients

Locations

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

815 Pollard Rd
Los Gatos, CA 95032
Phone (408) 378-6131

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

795 El Camino Real
#1112
Palo Alto, CA 94301

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

1033 Los Palos Dr
Salinas, CA 93901
Phone (831) 424-2866

611 Abbott St
Ste 101
Salinas, CA 93901
Phone (831) 676-3573

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

2506 Samaritan Ct
San Jose, CA 95124
Phone (408) 523-3870

2577 Samaritan Dr
Ste 810
San Jose, CA 95124
Phone (408) 358-0133

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: adiep561800@hisp.ehr.sutterhealth.org

Organizations & group practices 10

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.

Hospital & facility affiliations 4

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": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1962065805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "408-358-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 SAMARITAN DR STE 810",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244109",
            "telephone_number": "408-358-0133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 Abbott St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Salinas",
            "state": "CA",
            "postal_code": "939014391",
            "country_code": "US",
            "telephone_number": "831-757-3041",
            "fax_number": "831-757-4612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIEP",
        "first_name": "AMANDA",
        "middle_name": "AMY",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.