NPIMap

Individual provider Active NPI

Amanda L Smithers, PA-C

  • Medical Physician Assistant
  • Lakeport, CA
National Provider Identifier
1184052003
Registry record updated Aug 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0003843 Issued in CO
Practice address
5196 Hill Rd E Ste 300
Lakeport, CA 95453-6374
Phone
(707) 263-6885
NPI assigned
Oct 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2019

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 PA.0003843 CO Primary

Addresses

Primary practice location

5196 Hill Rd E Ste 300
Lakeport, CA 95453-6374

Mailing address

5196 Hill Rd E Ste 300
Lakeport, CA 95453-6374
Phone (707) 263-6885

Other practice location 1

7447 E Berry Ave
Suite 150
Greenwood Village, CO 80111-2146
Phone (303) 689-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180822003790 CA Practitioner - Physician Assistant 5193954840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Lakeside Home Medical ServicesGroup PAC ID 1850338054, 19 clinicians
Sutter Bay HospitalsGroup PAC ID 3476506528, 45 clinicians

Practice addresses (Care Compare)

5176 Hill Rd E
Lakeport, CA 95453-6300

Hospital & facility affiliations

  • Sutter Care at Home Home health agency, Lakeport, CA, CCN 057620
  • Adventist Health Home Care Services Home health agency, Lower Lake, CA, CCN 057710
  • Sutter Lakeside Hospital Hospital, Lakeport, CA, CCN 051329
  • Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317
  • Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301
  • California Pacific Medical Ctr-Davies Campus Hosp Hospital, San Francisco, CA, CCN 050008
  • Sutter Santa Rosa Regional Hospital Hospital, Santa Rosa, CA, CCN 050291

Merit-based Incentive Payment System (MIPS)

Final score
96.74 of 100Reported as group
Quality
80.2
Promoting interoperability
100
Improvement activities
40
Cost
76.39

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
73.31
Promoting interoperability
92
Improvement activities
40
Cost
62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0003843COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Hospitals CurrentSince Aug 13, 2018 Accepting new patients
Sutter Bay Hospitals CurrentSince Aug 13, 2018 Accepting new patients
St Lukes Health Care Center Past Accepting new patients

Locations

5176 Hill Rd E
Lakeport, CA 95453
Phone (707) 262-5000

5196 Hill Rd E
Ste 300
Lakeport, CA 95453
Phone (707) 263-6885

Interoperability endpoints

  • Direct secure messaging: asmithers378945@hisp.ehr.sutterhealth.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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1383177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565481600000",
    "number": "1184052003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5196 HILL RD E STE 300",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536374",
            "telephone_number": "707-263-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5196 HILL RD E STE 300",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536374",
            "telephone_number": "707-263-6885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7447 E Berry Ave",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Greenwood Village",
            "state": "CO",
            "postal_code": "801112146",
            "country_code": "US",
            "telephone_number": "303-689-2300",
            "fax_number": "303-689-2301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITHERS",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-31",
        "last_updated": "2019-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0003843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeport, CA

Sources for this page

Verify at the official NPI Registry.