Individual provider Active NPI

Ashime A Amandong

  • Home Health Aide
  • Upper Marlboro, MD
National Provider Identifier
1043766058
Registry record updated Mar 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA12361 Issued in DC
Practice address
1401 Merganser CT
Upper Marlboro, MD 20774-7017
Phone
(202) 971-6041
NPI assigned
Aug 30, 2016
Last updated
Mar 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X HHA12361 DC Primary

Addresses

Primary practice location

1401 Merganser CT
Upper Marlboro, MD 20774-7017

Mailing address

1401 Merganser CT
Upper Marlboro, MD 20774-7017
Phone (202) 971-6041

Other names 1

  • Ashime A Amandong Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HHA12361DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1043766058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MERGANSER CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207747017",
            "telephone_number": "202-971-6041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MERGANSER CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207747017",
            "telephone_number": "202-971-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMANDONG",
        "first_name": "ASHIME",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-30",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA12361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHIME",
            "last_name": "AMANDONG",
            "middle_name": "A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.