AMANDA MAE VERGEL DE DIOS
NPI 1679069058
Nurse Practitioner - Psychiatric/Mental Health in Santa Rosa, CA

Q: What is Amanda Mae Vergel De Dios's NPI number?

The NPI number for Amanda Mae Vergel De Dios is 1679069058. It was assigned to this individual provider in the NPPES registry on July 9, 2018.

Q: What is Amanda Mae Vergel De Dios's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since July 09, 2018PECOS EnrolledAccepts Medicare Assignment

1300 N DUTTON AVE, SANTA ROSA, CA 95401(707) 396-5151 Get Directions Write a Review

NPPES record last updated: July 31, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 27, 2023, Jul 9, 2018 (2 updates tracked since 2018).

On this page

About Amanda Mae Vergel De Dios NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA MAE VERGEL DE DIOS (NPI 1679069058) is an individual psychiatric/mental health provider in Santa Rosa, California, licensed in California (95025863) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1679069058

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameAMANDA MAE VERGEL DE DIOS

Location Address1300 N DUTTON AVESanta Rosa, CA 95401-7112

Mailing Address1300 N Dutton AveSanta Rosa, CA 95401-7112

Phone(707) 396-5151

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateJuly 9, 2018

Last NPPES UpdateJuly 31, 20232 updates tracked since enumeration

NPPES CertifiedJuly 31, 2023

✔ NPI 1679069058 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CA · 95025863

Also ListedCommunity Health WorkerTaxonomy 172V00000X

1300 N DUTTON AVE, Santa Rosa, CA 95401

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Amanda Mae Vergel De Dios is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID941646814

PECOS Enrollment IDI20240313003867

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Amanda Mae Vergel De Dios reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Santa Rosa Community Health Centers

Same address

Federally Qualified Health Center (FQHC)

1300 N DUTTON AVE
Santa Rosa, CA 95401

Reassigned Medicare billing, California enrollment
215 clinicians in this Medicare group

NPI 1780195255 (707) 303-3600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.16 typical visit price

range $63.04 – $187.01

Typical copayment $24.04 (range $15.76 – $46.75)

Most-billed visit code 99203

Established Patient

$109.88 typical visit price

range $21.02 – $153.40

Typical copayment $27.47 (range $5.25 – $38.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ERIN O. LIIV LCSW

Social Worker (Clinical)