Amantha Theodore

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN9364653 Issued in FL

Practice address

531 E Lincoln Ave Apt 4N
Mount Vernon, NY 10552-3743

Phone

(718) 920-9000

NPI assigned

Sep 15, 2020

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 FL

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Care Hospitalists PLGroup PAC ID 5092753632, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeland Regional Medical Center Hospital, Lakeland, FL, CCN 100157

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Advanced Care Hospitalists PL

  • Hospitalist Physician
  • Lakeland, FL
  • NPI 1457389587
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakeland Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Lakeland, FL
  • NPI 1144228446
  Care Compare affiliation

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1003421066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 E LINCOLN AVE APT 4N",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105523743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 E LINCOLN AVE APT 4N",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105523743",
            "telephone_number": "718-920-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODORE",
        "first_name": "AMANTHA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "RN9364653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Renaissance Project Inc Mt Vernon
• The Wartburg Home of the Evangelical Lutheran Church
• The Wartburg Home of the Evangelical Lutheran Church, Inc.
• The Wartburg Home of the Evangelical Lutheran Church, Inc.
• The Wartburg Residential Community, Inc.
• Therapy-Helps LCSW, PLLC
• Thomas Family Practice Family Health NP Services PLLC
• Sharryl Thomas Travis, BLS INSTRUCTOR
• Aarin Thomas
• Cara Jere Nea Thomas, LMHC

• Family Nurse Practitioner in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.