Amanda J Ben
Individual provider Active NPI Family Nurse Practitioner · Saint Charles, MO
NPI 1164049698 · NPPES record last updated Jun 30, 2020
Key facts
- NPI
- 1164049698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2020003743 (MO)
- Practice address
- 23 Terre Verte CT
Saint Charles, MO 63304-1217 - Phone
- (716) 228-0524
- NPI assigned
- Jun 30, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Total Access Urgent Care PC
Practice addresses (Care Compare)
9556 Manchester Rd
Saint Louis, MO 63119-1313
Phone (314) 961-2255
Merit-based Incentive Payment System (MIPS)
- Final score
- 42.87 of 100
- Quality
- 31.86
- Promoting interoperability
- 0
- Improvement activities
- 40
- Cost
- 61.04
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210428003109 | MO | Practitioner - Nurse Practitioner | 2769897768 | Reassigns benefits to 2 organizations |
| I20210510002596 | IL | Practitioner - Nurse Practitioner | 2769897768 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020003743 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alton Urgent Care Walk in Clinic Company | Current |
Accepting new patients | |
| Belleville Urgent Care Walk-in Clinic | Current |
Accepting new patients | |
| Waterloo Urgent Care Walk in Clinic Company | Current |
Accepting new patients | |
| Wood River Urgent Care and Walk in Clinic Inc | Current |
Accepting new patients | |
| Total Access Urgent Care, PC | Current |
Accepting new patients | |
| Total Access Urgent Care, PC | Current |
Accepting new patients | |
| Granite City Urgent Care Walk-in Clinic | Current |
Accepting new patients |
Locations
1417 Washington Ave
Alton, IL 62002
Phone (618) 260-0320
2801 W Main St
Belleville, IL 62226
Phone (618) 234-3053
2861 Madison Ave
Granite City, IL 62040
Phone (618) 709-7723
907 N Illinois Route 3
Waterloo, IL 62298
Phone (618) 350-0200
211 Madison Ave
Wood River, IL 62095
Phone (618) 709-7723
14671 Telegraph Rd
Redford, MI 48239
Phone (313) 387-2100
9556 Manchester Rd
Saint Louis, MO 63119
Phone (314) 373-5740
1717 Madison Ave
Washington, MO 63090
Phone (636) 244-6950
13861 Manchester Rd
Wildwood, MO 63011
Phone (636) 220-9333
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2020003743 | MO | Yes |
Addresses
Primary practice location
23 Terre Verte CT
Saint Charles, MO 63304-1217
Mailing address
23 Terre Verte CT
Saint Charles, MO 63304-1217
Phone (716) 228-0524
Other providers in Saint Charles, MO
- Marianne Swab Belcke
- Danielle Elizabeth Bell
- Bella'S Nurturing Hand, Inc.
- Janet Michelle Bellerson
- Kristin Bemis
- Benchmark Healthcare of St Charles, LLC
- Ashley Paige Benevice
- Mary Jean Bennett
- Hannah Bergstrom
- Harry N Bernard
All providers in Saint Charles, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.