Amanda Hope Champlain, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

S1782 Issued in TX

Practice address

4685 Eldorado Pkwy Ste 100
Frisco, TX 75033-0289

Phone

(972) 335-2727

Fax

(972) 668-8444

NPI assigned

Feb 24, 2012

Last updated

Oct 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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 TX

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

Specialty

Dermatology

Education

University of Oklahoma College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Revival Dermatology PLLCGroup PAC ID 7113321167, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.7 of 100Reported as group

Quality

100

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00246
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Revival Dermatology PLLC

  • Dermatology Physician
  • Dallas, TX
  • NPI 1679149702
  Medicare reassignment Care Compare group NPD
• Oliver Street 5.01(a) Inc.

  dba U.S. Dermatology Partners

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment NPD
• Dermatology Consultants of Frisco, P.a.

  • Dermatology Physician
  • Frisco, TX
  • NPI 1912194481
  NPD
• Westlake Dermatology of Dallas PLLC

  • Dermatology Physician
  • Dallas, TX
  • NPI 1710537782
  NPD
• Trinity Dermatology, P.a.

  • Dermatology Physician
  • Carrollton, TX
  • NPI 1184708786
  NPD (past)

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1003180993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4685 ELDORADO PKWY STE 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750330289",
            "telephone_number": "972-335-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4685 ELDORADO PKWY STE 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750330289",
            "telephone_number": "972-335-2727",
            "fax_number": "972-668-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPLAIN",
        "first_name": "AMANDA",
        "middle_name": "HOPE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-24",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "S1782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Scott Chalmers, D.C.
• Sheela Chamakala, PHARM. D.
• Shawn L Chamberlain, PAC
• Julie Chambers
• Hannah Champagne
• Gabrielle Elaine Chandler
• Kristina Lee Chandler, DDS
• Anoop Chandran, MD
• Chandratara, PA
• J. Summer-Rose Chaney, PSY.D.

• Dermatology Physician in Frisco, TX
• Providers in Frisco, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.