Active NPI
Amanda R Bonner, MD
- Geriatric Medicine (Internal Medicine) Physician
- Vancouver, WA
National Provider Identifier
1093073629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- MD60668472
- Practice address
- 2101 NE 139TH St
Suite #460
Vancouver, WA 98686 - Phone
- (360) 487-2727
- NPI assigned
- May 2, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD166587 | OR | |
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | MD60668472 | WA | Primary |
Addresses
Primary practice location
2101 NE 139TH St
Suite #460
Vancouver, WA 98686
Mailing address
PO Box 2077
Portland, OR 97208-2077
Phone (503) 413-3900
Other names 1
- Amanda M Rosen
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Geriatric Medicine
- Education
- University of Arizona College of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1919 NW Lovejoy St
Portland, OR 97209-1503
2101 NE 139TH St
Suite 460
Vancouver, WA 98686-2325
Phone (360) 487-2727
2211 NE 139TH St
Vancouver, WA 98686-2742
Phone 3604871000360487
Hospital & facility affiliations
- Centerwell Home Health
- Providence Home Health
- Legacy Salmon Creek Medical Center
- Salmon Creek Post Acute & Rehabilitation
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.83 of 100
- Quality
- 96.26
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.84
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD166587 | OR | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Clinics LLC | Internal Medicine | Current | Accepting new patients |
| Legacy Salmon Creek Hospital | Current | Accepting new patients | |
| Legacy Clinics LLC | Current | Accepting new patients | |
| Legacy Salmon Creek Hospital | Current | Accepting new patients | |
| Salmon Creek SNF Operations LLC | Past | Accepting new patients |
Locations
1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074
1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134
2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985
2101 NE 139th St
Ste 460
Vancouver, WA 98686
Phone (360) 487-2727
Interoperability endpoints
- arosen143523@direct.lhs.org
Organizations & group practices 6
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.
-
- Clinic/Center
- Vancouver, WA
- NPI 1356357784
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1700809829
-
- Rural Health Clinic/Center
- Sandy, OR
- NPI 1730472192
-
- Skilled Nursing Facility
- Vancouver, WA
- NPI 1851099873
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Vancouver, WA
- NPI 1205867819
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1700809829
-
- Home Health Agency
- Portland, OR
- NPI 1790873461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576368000000",
"number": "1093073629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2077",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972082077",
"telephone_number": "503-413-3900",
"fax_number": "503-413-3710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 NE 139TH ST",
"address_2": "SUITE #460",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98686",
"telephone_number": "360-487-2727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNER",
"first_name": "AMANDA",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-02",
"last_updated": "2019-12-15",
"certification_date": "2019-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD166587",
"primary": false
},
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "WA",
"license": "MD60668472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "ROSEN",
"middle_name": "M",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2019; 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.