Individual provider Active NPI

Amanda Elise Lipsitt, M.D.

  • Pediatric Hematology & Oncology Physician
  • San Antonio, TX
National Provider Identifier
1194145300
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
R4089 Issued in TX
Practice address
4410 Medical Dr Ste 550
San Antonio, TX 78229-3755
Phone
(210) 575-2222
Fax
(210) 575-6373
NPI assigned
Apr 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X BP10049374 TX
Pediatric Hematology & Oncology Physician 2080P0207X R4089 TX Primary

Addresses

Primary practice location

4410 Medical Dr Ste 550
San Antonio, TX 78229-3755

Mailing address

4410 Medical Dr Ste 550
San Antonio, TX 78229-3755
Phone (210) 575-2222

Other practice location 1

4900 Mueller Blvd
Austin, TX 78723-3079
Phone (512) 324-0165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220809003004 TX Practitioner - Pediatric Medicine 5991187866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Physician Practices PLLCGroup PAC ID 8022171974, 176 clinicians

Practice addresses (Care Compare)

4410 Medical Dr
Suite 550
San Antonio, TX 78229-3755
Phone (210) 575-2222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10049374TXMDPediatrics Physician
R4089TXMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Physician Practices, PLLC Pediatric Hematology-Oncology CurrentSince Sep 1, 2022 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
Fl 4
San Antonio, TX 78205
Phone (210) 297-7195

4410 Medical Dr
Ste 550
San Antonio, TX 78229
Phone (210) 575-2222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16700/brand/2/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1398556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1194145300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 MEDICAL DR STE 550",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293755",
            "telephone_number": "210-575-2222",
            "fax_number": "210-575-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 MEDICAL DR STE 550",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293755",
            "telephone_number": "210-575-2222",
            "fax_number": "210-575-6373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 Mueller Blvd",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787233079",
            "country_code": "US",
            "telephone_number": "512-324-0165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIPSITT",
        "first_name": "AMANDA",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-27",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP10049374",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "TX",
            "license": "R4089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.