Individual provider Active NPI

Amanda Baumann, PT, DPT

  • Physical Therapist
  • Kalamazoo, MI
National Provider Identifier
1003386830
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501018873 Issued in MI
Practice address
3025 Gull Rd
Kalamazoo, MI 49048-1281
Phone
(269) 552-5530
NPI assigned
Dec 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501018873 MI Primary

Addresses

Primary practice location

3025 Gull Rd
Kalamazoo, MI 49048-1281

Mailing address

3025 Gull Rd
Kalamazoo, MI 49048-1281

Other names 1

  • Amanda Borieo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201208001795 MI Practitioner - Physical Therapist in Private Practice 3375955859 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physical Therapy Group LLC Physical Therapist CurrentSince Dec 7, 2020 Accepting new patients

Locations

607 Dewey Ave NW
Ste 300
Grand Rapids, MI 49504
Phone (253) 332-3398

601 Michigan Ave
Ste 220
Holland, MI 49423
Phone (616) 355-4284

2020 Gull Rd
Kalamazoo, MI 49048
Phone (269) 234-2941

6016 Lovers Ln
Ste 3
Portage, MI 49002
Phone (269) 248-1946

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.

NPI Registry JSON

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1003386830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481281",
            "telephone_number": "269-552-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMANN",
        "first_name": "AMANDA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-05",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BORIEO",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.