Amanda Mosed
Individual provider Active NPI Adult Health Nurse Practitioner · New Boston, MI
NPI 1083563423 · NPPES record last updated Jan 27, 2026
Key facts
- NPI
- 1083563423
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 4704306260 (MI)
- Practice address
- 22639 Rust Rd
New Boston, MI 48164-9665 - Phone
- (313) 980-7772
- NPI assigned
- Jan 27, 2026
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Complexcare Medical Group Midwest M PLLC
Practice addresses (Care Compare)
41795 W 12 Mile Rd
Novi, MI 48377-3107
Phone (248) 533-0222
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260429002008 | MI | Practitioner - Nurse Practitioner | 6406323252 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704306260 | MI | MD | Adult Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner |
363LA2200X | 4704306260 | MI | Yes |
Addresses
Primary practice location
22639 Rust Rd
New Boston, MI 48164-9665
Mailing address
22639 Rust Rd
New Boston, MI 48164-9665
Phone (313) 980-7772
Other providers in New Boston, MI
- Cheryl Lamar
- Makk Group LLC
- Toms P Mathew
- Medpro Primary Care PLLC
- Dario Merlos
- MTT FNP LLC
- New Beginnings Counseling Center LLC
- New Boston Dental Clinic PC
- New Boston Family Dental
- Pamula Pinter
All providers in New Boston, MI · Adult Health Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.