Individual provider Active NPI

Amber N Condezza, PA

  • Medical Physician Assistant
  • Johnstown, PA
National Provider Identifier
1114247608
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA053861 Issued in PA
Practice address
1 Tech Park Dr
Johnstown, PA 15901-2515
Phone
(814) 475-8600
NPI assigned
Jun 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA053861 PA Primary

Addresses

Primary practice location

1 Tech Park Dr
Johnstown, PA 15901-2515

Mailing address

142 Work Dr
Johnstown, PA 15904-3313
Phone (814) 421-2102

Other names 1

  • Amber N Haupt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20101216000713 PA Practitioner - Physician Assistant 5890983969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DLP Conemaugh Physician Practices LLCGroup PAC ID 7315166949, 286 clinicians

Practice addresses (Care Compare)

1 Tech Park Dr
Johnstown, PA 15901-2515
Phone (814) 534-6750

1086 Franklin St
Johnstown, PA 15905-4305

1086 Franklin St E
Johnstown, PA 15905-4305
Phone (814) 534-9104

1086 Franklin St M
Johnstown, PA 15905-4305
Phone (814) 534-9194

1111 Franklin St
Johnstown, PA 15905-4341

Hospital & facility affiliations

  • Conemaugh Memorial Medical Center Hospital, Johnstown, PA, CCN 390110

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Physician Practices LLC CurrentSince Sep 1, 2014 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Sep 1, 2014 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

236 Jamesway Rd
Ebensburg, PA 15931
Phone (814) 471-6595

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1 Tech Park Dr
Johnstown, PA 15901
Phone (814) 475-8600

Interoperability endpoints

  • Direct secure messaging: acondezza5584@direct.conemaugh.org

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": "1275868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1114247608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 WORK DR",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043313",
            "telephone_number": "814-421-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TECH PARK DR",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159012515",
            "telephone_number": "814-475-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDEZZA",
        "first_name": "AMBER",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-07",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA053861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "HAUPT",
            "middle_name": "N",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.