Individual provider Active NPI

Amanda Masters, M.D.

  • Pediatrics Physician
  • Lubbock, TX
National Provider Identifier
1124211321
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M8720 Issued in TX
Practice address
4004 82ND St Ste C
Lubbock, TX 79423-2065
Phone
(806) 743-7800
Fax
(806) 743-7651
NPI assigned
Aug 21, 2007
Last updated
Nov 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X M8720 TX Primary

Addresses

Primary practice location

4004 82ND St Ste C
Lubbock, TX 79423-2065

Mailing address

PO Box 5865
Lubbock, TX 79408-5865
Phone (806) 743-2898

Other practice location 1

3601 4th St
Lubbock, TX 79430-0002
Phone (806) 743-7337

Other identifiers 1

IdentifierTypeStateIssuer
195187301MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amanda.masters@direct.myteamcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080911000100 TX Practitioner - Pediatric Medicine 0648346940 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M8720TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Feb 4, 2010 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock Pediatrics CurrentSince Feb 4, 2010 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
Lubbock County Hospital District Past Accepting new patients

Locations

3502 9th St
Ste 130
Lubbock, TX 79415
Phone (806) 743-1188

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

4004 82nd St
Ste C
Lubbock, TX 79423
Phone (806) 743-7800

Interoperability endpoints

  • Direct secure messaging: amanda.masters@direct.myteamcare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1124211321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5865",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794085865",
            "telephone_number": "806-743-2898",
            "fax_number": "806-743-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 82ND ST STE C",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794232065",
            "telephone_number": "806-743-7800",
            "fax_number": "806-743-7651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794300002",
            "country_code": "US",
            "telephone_number": "806-743-7337",
            "fax_number": "806-743-7329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTERS",
        "first_name": "AMANDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-21",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M8720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195187301",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amanda.masters@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "4004 82nd St Ste C",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794232065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.