Individual provider Active NPI

Amanda Catherine Koziel, MD

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1134611742
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26513 Issued in NV
Practice address
5380 S Rainbow Blvd Ste 120
Las Vegas, NV 89118-1878
Phone
(702) 463-4040
NPI assigned
May 31, 2018
Last updated
Nov 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26513 NV Primary
Family Medicine Physician 207Q00000X 286831 MA

Addresses

Primary practice location

5380 S Rainbow Blvd Ste 120
Las Vegas, NV 89118-1878

Mailing address

1454 Madison Ave W
Immokalee, FL 34142-2200
Phone (239) 658-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231012002550 FL Practitioner - Family Practice 2365788601 Reassigns benefits to 1 organization
I20250815003449 NV Practitioner - Family Practice 2365788601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roseman Medical Research InstituteGroup PAC ID 0244522795, 3 clinicians

Practice addresses (Care Compare)

5380 S Rainbow Blvd
Suite 120
Las Vegas, NV 89118-1878
Phone (702) 463-4040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26513NVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roseman Medical Research Institute, LLC Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Collier Health Services, Inc CurrentSince Nov 7, 2023 Accepting new patients
Collier Health Services Inc CurrentSince Nov 7, 2023 Accepting new patients

Locations

1454 Madison Ave W
Immokalee, FL 34142
Phone (239) 658-3064

2355 Stanford Ct
#701
Naples, FL 34112
Phone (239) 244-1356

5380 S Rainbow Blvd
Ste 120
Las Vegas, NV 89118
Phone (702) 233-3444

Interoperability endpoints

  • Direct secure messaging: amanda.koziel.p1@direct.chcfhc.nextgenshare.com

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, 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": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1134611742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 MADISON AVE W",
            "city": "IMMOKALEE",
            "state": "FL",
            "postal_code": "341422200",
            "telephone_number": "239-658-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 S RAINBOW BLVD STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181878",
            "telephone_number": "702-463-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZIEL",
        "first_name": "AMANDA",
        "middle_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "26513",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "286831",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.