Individual provider Active NPI

Amanda Keri Lum, DNP, APRN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Pinellas Park, FL
National Provider Identifier
1184455651
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11033844 Issued in FL
Practice address
6580 72ND Ave N Ste a
Pinellas Park, FL 33781-4047
Phone
(727) 440-5612
Fax
(727) 388-3767
NPI assigned
Aug 8, 2024
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11033844 FL Primary

Addresses

Primary practice location

6580 72ND Ave N Ste a
Pinellas Park, FL 33781-4047

Mailing address

PO Box 10970
Saint Petersburg, FL 33733-0970

Other practice location 1

4024 Central Ave
Saint Petersburg, FL 33711-1239
Phone (727) 327-7656

Other identifiers 1

IdentifierTypeStateIssuer
125498200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250408003911 FL Practitioner - Nurse Practitioner 6103340443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Syed K Zaidi MD PAGroup PAC ID 4587736277, 7 clinicians

Practice addresses (Care Compare)

6580 72ND Ave N
Suite a
Pinellas Park, FL 33781-4047
Phone (727) 440-5612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11033844FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Syed K Zaidi MD PA CurrentSince Mar 1, 2025 Accepting new patients
Addiction and Psychiatric Care, LLC Past Accepting new patients

Locations

6580 72nd Ave N
Pinellas Park, FL 33781
Phone (727) 440-5612

6580 72nd Ave N
Ste A
Pinellas Park, FL 33781
Phone (727) 440-5612

Organizations & group practices 2

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": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1184455651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10970",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337330970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6580 72ND AVE N STE A",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337814047",
            "telephone_number": "727-440-5612",
            "fax_number": "727-388-3767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4024 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Petersburg",
            "state": "FL",
            "postal_code": "337111239",
            "country_code": "US",
            "telephone_number": "727-327-7656",
            "fax_number": "727-323-8978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUM",
        "first_name": "AMANDA",
        "middle_name": "KERI",
        "credential": "DNP, APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-08",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11033844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125498200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

Verify at the official NPI Registry.