Active NPI
Amanda Lundberg, MSN, RN, FNP-BC
- Family Nurse Practitioner
- South Bend, IN
National Provider Identifier
1023400454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71005353A
- Practice address
- 53830 Generations Dr Ste 110
South Bend, IN 46635-1538 - Phone
- (574) 234-2191
- NPI assigned
- Feb 23, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71005353A | IN | Primary |
Addresses
Primary practice location
53830 Generations Dr Ste 110
South Bend, IN 46635-1538
Mailing address
53830 Generations Dr Ste 110
South Bend, IN 46635-1538
Phone (574) 234-2191
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, GA, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1740 84TH St
Brooklyn, NY 11214-2825
Phone (718) 855-8584
22 Maple Ridge Dr
Cartersville, GA 30121-2228
Phone (718) 534-0689
3111 Church PL
Duluth, MN 55811-2925
Phone (212) 734-6621
Merit-based Incentive Payment System (MIPS)
- Final score
- 20.03 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 66.77
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner, Registered Nurse
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Brooklyn, NY
- NPI 1518415983
GA, MN
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424649600000",
"number": "1023400454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53830 GENERATIONS DR STE 110",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351538",
"telephone_number": "574-234-2191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53830 GENERATIONS DR STE 110",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351538",
"telephone_number": "574-234-2191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDBERG",
"first_name": "AMANDA",
"credential": "MSN, RN, FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-23",
"last_updated": "2015-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71005353A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.