Amanda Jo Prestigiacomo, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

55632 Issued in ID

Practice address

350 N Haven Dr
Twin Falls, ID 83301-5788

Phone

(208) 904-4780

Fax

(208) 904-4832

NPI assigned

May 15, 2017

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 ID

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
• St Luke'S Wood River Medical Center Hospital, Ketchum, ID, CCN 131323
• St Luke'S Jerome Hospital, Jerome, ID, CCN 131310
• Minidoka Memorial Hospital Hospital, Rupert, ID, CCN 131319
• St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aprestigiacomo32456@direct.slhs.org
• Direct secure messaging: amandaprestigiacomo@ikillp.allscriptsdirect.net

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.

• St Luke'S Clinic LLC

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1790718229
  Medicare reassignment Care Compare group NPD
• Idaho Kidney Institute LLP

  • Nephrology Physician
  • Chubbuck, ID
  • NPI 1013064690
  Medicare reassignment NPD
• Visions Home Health & Visions Home Care, LLC

  • Home Health Agency
  • Twin Falls, ID
  • NPI 1235137761
  Medicare reassignment NPD
• St Luke'S Magic Valley Regional Medical Center LTD

  • Community/Retail Pharmacy
  • Twin Falls, ID
  • NPI 1760203921
  NPD (past)
• Transtreme, LLC

  • Family Nurse Practitioner
  • Kansas City, MO
  • NPI 1003290453
  NPD (past)

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

• Minidoka Memorial Hospital

  • Critical Access Hospital
  • Rupert, ID
  • NPI 1679553531
  Care Compare affiliation
• St Luke'S Magic Valley Regional Medical Center LTD

  • Critical Access Hospital
  • Jerome, ID
  • NPI 1366874877
  Care Compare affiliation
• St Lukes Regional Medical Center

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation
• St Lukes Wood River Medical Center LTD

  • Critical Access Hospital
  • Ketchum, ID
  • NPI 1508869470
  Care Compare affiliation
• St. Luke'S Magic Valley Regional Medical Center, LTD.

  • General Acute Care Hospital
  • Twin Falls, ID
  • NPI 1932154705
  Care Compare affiliation

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1043747579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268934",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731268934",
            "telephone_number": "208-904-4780",
            "fax_number": "208-904-4832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N HAVEN DR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015788",
            "telephone_number": "208-904-4780",
            "fax_number": "208-904-4832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTIGIACOMO",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-15",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "55632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Preferred Child and Family Services, Inc
• Preferred Child and Family Services, Inc.
• Premier Home Sleep Testing
• Premier Life Wellness LLC
• Kent H Pressman, MD
• Amy A Prestin, LCPC
• Daniel G Preucil, M.D.
• Jennifer L Preucil, M.D.
• Janice Preuit
• Primary Therapy Source LLC

• Nurse Practitioner in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.