Clifford Amos, PA

Key facts

NPI

1023098514

Entity type

Individual (NPI type 1)

Primary specialty

Physician Assistant 363A00000X

License

102426 (NC)

Practice address

200 Harry S Truman Pkwy
Annapolis, MD 21401-7601

Phone

(410) 897-0272

Fax

(410) 897-1968

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 4

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 Dermatology of Maryland PC Dermatology Physician · Rockville, MD · NPI 1760856413
  Medicare reassignment Care Compare group NPD (past) DC · MD
• Polley Clinic of Dermatology & Dermatologic Surgery Dermatopathology Physician · Wilson, NC · NPI 1104847714
  Medicare reassignment NC
• Advanced Dermatology of Maryland PC Dermatology Physician · Fort Washington, MD · NPI 1386479004
  NPD
• Advanced Dermatology of Maryland PC Dermatology Physician · Annapolis, MD · NPI 1811722523
  NPD

Medicare Care Compare profile

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology of Maryland PC (43 clinicians)

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.97 of 100 (group)

Quality

78.47

Promoting interoperability

83

Improvement activities

40

Cost

82.27

Medicare participation

Medicare fee-for-service enrollment

Enrolled (3 enrollments) in NC, MD, DC

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Physician Assistant

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 17, 2021.

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1023098514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HARRY S TRUMAN PKWY",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017601",
            "telephone_number": "410-897-0272",
            "fax_number": "410-897-1968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HARRY S TRUMAN PKWY",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017601",
            "telephone_number": "410-897-0272",
            "fax_number": "410-897-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMOS",
        "first_name": "CLIFFORD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "102426",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1736V",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887475100",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8102548",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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