Amanda Leah Paczkowski, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP016405 Issued in PA

Practice address

1000 Higbee Dr
Suite D 202
Bethel Park, PA 15102-4200

Phone

(412) 833-6176

Fax

(412) 833-6421

NPI assigned

Oct 28, 2016

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dramandapaczkowsi@southhillsfamilymedicine.medentdirect.com

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.

• South Hills Family Medicine, LLC

  • Family Medicine Physician
  • Bethel Park, PA
  • NPI 1497705784
  Medicare reassignment NPD
• South Hills Family Medicine, LLC

  • Family Medicine Physician
  • Homestead, PA
  • NPI 1447200662
  NPD (past)

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536969600000",
    "number": "1003368770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HIGBEE DR",
            "address_2": "SUITE D 202",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151024200",
            "telephone_number": "412-833-6176",
            "fax_number": "412-833-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HIGBEE DR",
            "address_2": "SUITE D 202",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151024200",
            "telephone_number": "412-833-6176",
            "fax_number": "412-833-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACZKOWSKI",
        "first_name": "AMANDA",
        "middle_name": "LEAH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-28",
        "last_updated": "2018-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP016405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1034419410001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Obisidian Exceptional Eyewear LLC
• Christina M Ohm, L.P.C.
• David A Ohm, MA, ATR-BC, LPC, NCC
• Karin Sue Oltyan, M.D.
• Nathaniel Thomas Ondeck, MD, MHS
• Nancy Johnson Page, RD,LDN
• Susan D. Palladino, MA,CCC,SLP
• Laura Ann Palmer, CRNA
• Nicholas D Palmer, DDS
• Paramount Senior Living at Bethel Park LLC

• Family Nurse Practitioner in Bethel Park, PA
• Providers in Bethel Park, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.