Individual provider Active NPI

Amanda C McDonagh, PA-C

  • Surgical Physician Assistant
  • Cedar Rapids, IA
National Provider Identifier
1114580495
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
095388 Issued in IA
Practice address
788 8TH Ave SE Ste 300
Cedar Rapids, IA 52401-2106
Phone
(319) 398-6747
NPI assigned
Apr 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 095388 IA Primary

Addresses

Primary practice location

788 8TH Ave SE Ste 300
Cedar Rapids, IA 52401-2106

Mailing address

15496 Abbey Cir
Peosta, IA 52068-9678
Phone (563) 590-3616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20190701001993 IA Practitioner - Physician Assistant 3577897198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Medical CenterGroup PAC ID 4183535271, 295 clinicians

Practice addresses (Care Compare)

701 10TH St SE
Cedar Rapids, IA 52403-1251

701 10TH St SE
Cedar Rapids, IA 52403-1292

701 10TH St SE J Edward Lundy
Mercy Pediatric Clinic
Cedar Rapids, IA 52403-1251
Phone (319) 832-2328

788 8TH Ave SE
Cedar Rapids, IA 52401-2106

Hospital & facility affiliations

  • Mercy Medical Center - Cedar Rapids Hospital, Cedar Rapids, IA, CCN 160079

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
095388IAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center CurrentSince Jun 1, 2019 Accepting new patients
Mercy Medical Center CurrentSince Jun 1, 2019 Accepting new patients

Locations

788 8th Ave SE
Ste 300
Cedar Rapids, IA 52401
Phone (319) 369-4542

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

Organizations & group practices 3

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": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1114580495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15496 ABBEY CIR",
            "city": "PEOSTA",
            "state": "IA",
            "postal_code": "520689678",
            "telephone_number": "563-590-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 8TH AVE SE STE 300",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524012106",
            "telephone_number": "319-398-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONAGH",
        "first_name": "AMANDA",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IA",
            "license": "095388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.