NPIMap

Individual provider Active NPI

Amanda Whitewood, PA-C

  • Medical Physician Assistant
  • Stroudsburg, PA
National Provider Identifier
1124718648
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
208 Lifeline Rd
Stroudsburg, PA 18360-6473
Phone
(272) 212-3872
NPI assigned
May 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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 Primary

Addresses

Primary practice location

208 Lifeline Rd
Stroudsburg, PA 18360-6473

Mailing address

208 Lifeline Rd
Stroudsburg, PA 18360-6473

Other practice location 1

239 E Brown St
East Stroudsburg, PA 18301-3005
Phone (272) 212-3872

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230822002448 PA Practitioner - Physician Assistant 1456713544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians
University of Penn-Medical GroupGroup PAC ID 6204730955, shared by 15 NPIs, 3,433 clinicians

Practice addresses (Care Compare)

208 Lifeline Rd
Stroudsburg, PA 18360-6473

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-4000

4311 Easton Ave
Bethlehem, PA 18020-1431
Phone (610) 954-3600

4379 Easton Ave
101 Family Prac Palmer
Bethlehem, PA 18020-1431
Phone (610) 814-2424

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Physician Group Inc CurrentSince Jul 31, 2023 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Jul 31, 2023 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients

Locations

4311 Easton Ave
Bethlehem, PA 18020
Phone (610) 954-3600

239 E Brown St
East Stroudsburg, PA 18301
Phone (570) 421-3872

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

208 Lifeline Rd
Ste 202
Stroudsburg, PA 18360
Phone (272) 212-2141

Interoperability endpoints

  • Direct secure messaging: amanda.whitewood@slpg.direct-sluhn.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1124718648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 LIFELINE RD",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183606473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 LIFELINE RD",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183606473",
            "telephone_number": "272-212-3872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "239 E Brown St",
            "address_purpose": "LOCATION",
            "city": "East Stroudsburg",
            "state": "PA",
            "postal_code": "183013005",
            "country_code": "US",
            "telephone_number": "272-212-3872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITEWOOD",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.