Individual provider Active NPI

Amanda Thiergartner, PA-C

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1104101229
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001341A Issued in IN
Practice address
2001 W 86TH St
Indianapolis, IN 46260-1902
Phone
(317) 338-2345
Fax
(317) 338-2345
NPI assigned
Oct 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001341A IN Primary

Addresses

Primary practice location

2001 W 86TH St
Indianapolis, IN 46260-1902

Mailing address

2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (317) 338-2345

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amanda.thiergartner.1@7598.direct.athenahealth.com ST VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20111212000471 IN Practitioner - Physician Assistant 8527233097 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Jun 23, 2021 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center Physician Assistant CurrentSince Jun 23, 2021 Accepting new patients
St Vincent Pediatric Subspecialties CurrentSince Sep 30, 2021 Accepting new patients
Emergency Medicine Physicians of Hamilton County, LTD. Past Accepting new patients

Locations

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

Organizations & group practices 5

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": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1104101229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-338-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-338-2345",
            "fax_number": "317-338-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIERGARTNER",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001341A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amanda.thiergartner.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "ST VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER",
            "address_1": "2001 W 86th St",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462601902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.