Individual provider Active NPI

Nancy Amodei, PHD

  • Psychologist
  • San Antonio, TX
National Provider Identifier
1053323014
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
23754 Issued in TX
Practice address
4242 Medical Dr Ste 7100
San Antonio, TX 78229-5397
Phone
(210) 342-1906
Fax
(210) 570-8203
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 23754 TX Primary

Addresses

Primary practice location

4242 Medical Dr Ste 7100
San Antonio, TX 78229-5397

Mailing address

4242 Medical Dr Ste 7100
San Antonio, TX 78229-5397
Phone (210) 342-1906

Other identifiers 2

IdentifierTypeStateIssuer
035550502MedicaidTX
035550501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060828000511 TX Practitioner - Clinical Psychologist 1850395138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Offices of Michael a Roman PHDGroup PAC ID 1759649981, 3 clinicians

Practice addresses (Care Compare)

4242 Medical Dr
Suite 7100
San Antonio, TX 78229-5397
Phone (210) 342-1906

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

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.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1053323014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4242 MEDICAL DR STE 7100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295397",
            "telephone_number": "210-342-1906",
            "fax_number": "210-570-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 MEDICAL DR STE 7100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295397",
            "telephone_number": "210-342-1906",
            "fax_number": "210-570-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMODEI",
        "first_name": "NANCY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "23754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035550502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035550501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.