Amanda Marie Minervini, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

122390029934 Issued in UT

Practice address

5357 S Baker St
Murray, UT 84107-6374

Phone

(973) 479-0136

NPI assigned

Jun 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• UT PPO D-SNP
• UT PPO

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.

• Generalhealthgroup of Utah

  • Ophthalmology Physician
  • Salt Lake City, UT
  • NPI 1538804968
  NPD
• In Sight Optics, Inc

  • Optician
  • Denville, NJ
  • NPI 1477718252
  NPD (past)

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1184240780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5357 S BAKER ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076374",
            "telephone_number": "973-479-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5357 S BAKER ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076374",
            "telephone_number": "973-479-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINERVINI",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-19",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA695800",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "122390029934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Millet, CCC-SLP
• Heather N Mills, RN
• Amy Miner, MD
• Lonnie Jefferson Miner, M.D.
• Sharlene A Miner, MD
• Brook Mingo, CMHC
• Joshua J Minori, DO
• Mitchell J Rohrback, MD PC
• Anthony Mitchell
• Mackenzie Mitchell

• Optometrist in Murray, UT
• Providers in Murray, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.