Individual provider Active NPI

Amanda Mittelstetter, CRNP

  • Nurse Practitioner
  • Catonsville, MD
National Provider Identifier
1063009694
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R218961 Issued in MD
Practice address
910 Frederick Rd
Catonsville, MD 21228-4516
Phone
(410) 644-1880
Fax
(410) 646-3623
NPI assigned
Dec 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R218961 MD
Nurse Practitioner 363L00000X R218961 MD Primary

Addresses

Primary practice location

910 Frederick Rd
Catonsville, MD 21228-4516

Mailing address

910 Frederick Rd
Catonsville, MD 21228-4516
Phone (410) 644-1880

Other practice location 1

5601 Loch Raven Blvd
Baltimore, MD 21239-2945
Phone (443) 444-4055

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20210225001286 MD Practitioner - Nurse Practitioner 7113332198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centers for Advanced Orthopaedics LLCGroup PAC ID 8123260981, 599 clinicians

Practice addresses (Care Compare)

910 Frederick Rd
Catonsville, MD 21228-4516
Phone (410) 644-1880

Hospital & facility affiliations

  • The Lutheran Village At Miller's Grant Nursing home, Ellicott City, MD, CCN 215363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R218961MDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Feb 17, 2025 Accepting new patients
Centers for Advanced Orthopaedics, LLC Nurse Practitioner CurrentSince Feb 17, 2025 Accepting new patients
Centers for Advanced Orthopaedics, LLC Current Accepting new patients
Orthopaedic Associates of Central Maryland, PA Past Accepting new patients

Locations

910 Frederick Rd
Catonsville, MD 21228

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

Interoperability endpoints

  • Direct secure messaging: 17amittelstetter@cfaortho.emadirect.md

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1063009694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 FREDERICK RD",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284516",
            "telephone_number": "410-644-1880",
            "fax_number": "410-646-3623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 FREDERICK RD",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284516",
            "telephone_number": "410-644-1880",
            "fax_number": "410-646-3623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5601 Loch Raven Blvd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212392945",
            "country_code": "US",
            "telephone_number": "443-444-4055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITTELSTETTER",
        "first_name": "AMANDA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-29",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R218961",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R218961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Catonsville, MD

Sources for this page

Verify at the official NPI Registry.