Elisa Amador

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

9806346-4405 Issued in UT

Practice address

12428 S Mossberg Dr
Herriman, UT 84096-7784

Phone

(801) 493-5945

NPI assigned

Aug 19, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Arizona College of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Exodus Healthcare Network PLLCGroup PAC ID 1456265057, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: elisa.amador.1@11893.direct.athenahealth.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.

• Exodus Healthcare Network PLLC

  • Family Medicine Physician
  • Magna, UT
  • NPI 1306952783
  Medicare reassignment Care Compare group
• Magna Eyecare, L.L.C.

  • Optometrist
  • Magna, UT
  • NPI 1144826066
  NPD (past)
• Mobile Eyecare of Utah LLC

  • Optometrist
  • Magna, UT
  • NPI 1245274521
  NPD (past)

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1023620168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12428 S MOSSBERG DR",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840967784",
            "telephone_number": "801-493-5945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12428 S MOSSBERG DR",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840967784",
            "telephone_number": "801-493-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMADOR",
        "first_name": "ELISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SW0102X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Women's Health",
            "state": "UT",
            "license": "9806346-3102",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "9806346-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abundant Dental Care, P.C.
• Anna Lee Adams, RPH
• Aetos LLC
• Marie Alexander, MSN, PMHNP-BC, APRN
• Lindsey Anne Alldredge
• Chad O Anderson, O.D.
• Hayleigh Electa Anderson
• Kay Ruth Anderson, ATC
• Apiary Management Group
• Tierney Kalila Araujo

• Nurse Practitioner in Herriman, UT
• Providers in Herriman, UT by specialty
• Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.