Organization Active NPI

Amanda Stewart Family Health Nurse Practitioner

  • Family Nurse Practitioner
  • Utica, NY
National Provider Identifier
1023817442
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
AMANDA STEWART FAMILY HEALTH NURSE PRACTITIONER
Practice address
2604 Genesee St
Utica, NY 13502-6003
Phone
(631) 455-1259
NPI assigned
Mar 10, 2025
Last updated
Mar 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Authorized official

Name
Amanda StewartNPI 1619384377
Title
FNP
Phone
(631) 455-1259

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2604 Genesee St
Utica, NY 13502-6003

Mailing address

2604 Genesee St
Utica, NY 13502-6003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250318000940 NY Part B Supplier - Clinic/Group Practice 3971025107 Receives reassigned benefits from 1 practitioner
Practice locations: Utica, NY

National Provider Directory

National Provider Directory

Locations

2604 Genesee St
Utica, NY 13502
Phone (315) 735-6441

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1023817442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026003",
            "telephone_number": "631-455-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA STEWART FAMILY HEALTH NURSE PRACTITIONER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "631-455-1259"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.