Amanda Lyn Fidiam, PA-C
Individual provider Active NPI Medical Physician Assistant · Moosic, PA
NPI 1003193202 · NPPES record last updated Sep 4, 2014
Key facts
- NPI
- 1003193202
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- MA055142 (PA)
- Practice address
- 340 Montage Mountain Rd
Moosic, PA 18507-1782 - Phone
- (570) 346-3686
- Fax
- (570) 558-6838
- NPI assigned
- Nov 16, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Matthew a Berger MD PC
Practice addresses (Care Compare)
340 Montage Mountain Rd
Moosic, PA 18507-1707
Phone (570) 346-3686
340 Montage Mountain Rd
Moosic, PA 18507-1782
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.34 of 100
- Quality
- 69.53
- Promoting interoperability
- 80
- Improvement activities
- 40
- Cost
- 67.59
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111117000128 | PA | Practitioner - Physician Assistant | 2860666492 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Interoperability endpoints
- amandaf@berger.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA055142 | PA | Yes |
Addresses
Primary practice location
340 Montage Mountain Rd
Moosic, PA 18507-1782
Mailing address
340 Montage Mountain Rd
Moosic, PA 18507-1782
Phone (570) 346-3686
Other names
- Miss Amanda Lyn Beck
Other providers in Moosic, PA
- Jane Drasba
- Marian Louise Farrell
- Joseph James Fauzio Jr.
- Joseph Feistl
- Jessica Fetchick
- Erin Fiske
- Jacob Wesley Frazier
- Robert J French Jr.
- Rachel Galati
- Geisinger Clinic
All providers in Moosic, PA · Medical Physician Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.