Individual provider Active NPI

Syeda Ameena

  • Internal Medicine Physician
  • Fontana, CA
National Provider Identifier
1972998706
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
153093 Issued in CA
Practice address
7774 Cherry Ave
Fontana, CA 92336-4014
Phone
(909) 355-1296
NPI assigned
Mar 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 153093 CA Primary

Addresses

Primary practice location

7774 Cherry Ave
Fontana, CA 92336-4014

Mailing address

7774 Cherry Ave
Fontana, CA 92336-4014
Phone (909) 355-1296

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190412001853 CA Practitioner - Internal MedicinePractitioner - Family Practice 2769781210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Comprehensive Primary Care Medical Associates, IncGroup PAC ID 5092780833, 4 clinicians

Practice addresses (Care Compare)

7774 Cherry Ave
Fontana, CA 92336-4014
Phone (909) 355-1296

Hospital & facility affiliations

  • Casa Colina Hospital Hospital, Pomona, CA, CCN 050782

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
153093CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Compre Hensive Primary Care Medical Associates, Inc CurrentSince Oct 1, 2021 Accepting new patients

Locations

7774 Cherry Ave
Fontana, CA 92336
Phone (909) 355-1296

7798 Cherry Ave
Fontana, CA 92336
Phone (909) 355-1296

1800 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 355-1296

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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 2

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1972998706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7774 CHERRY AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364014",
            "telephone_number": "909-355-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7774 CHERRY AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364014",
            "telephone_number": "909-355-1296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMEENA",
        "first_name": "SYEDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "153093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.