Amy Broadwater, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA002774L Issued in PA

Practice address

236 Elm Dr Ste 101
Waynesburg, PA 15370-8265

Phone

(724) 627-0926

Fax

(724) 627-0812

NPI assigned

Jun 28, 2006

Last updated

Sep 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA, WV2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abroadwater21429@gohealthupmc.direct-ci.com

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.

• Urgent Care, PC - Pennsylvania

  • Emergency Medicine Physician
  • Pittsburgh, PA
  • NPI 1982839031
  Medicare reassignment
• Urgent Care, Inc.- West Virginia

  • Urgent Care Clinic/Center
  • South Charleston, WV
  • NPI 1912133315
  Medicare reassignment
• Medexpress Urgent Care, PC - Pennsylvania

  dba MedExpress Urgent Care - North Huntingdon

  • Urgent Care Clinic/Center
  • North Huntingdon, PA
  • NPI 1043583602
  NPD
• Medexpress Urgent Care, PC - Pennsylvania

  dba MedExpress Urgent Care - St. Clair, Clover Dr

  • Urgent Care Clinic/Center
  • Saint Clair, PA
  • NPI 1720545320
  NPD

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1194753327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 ELM DR STE 101",
            "city": "WAYNESBURG",
            "state": "PA",
            "postal_code": "153708265",
            "telephone_number": "724-627-0926",
            "fax_number": "724-627-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 ELM DR STE 101",
            "city": "WAYNESBURG",
            "state": "PA",
            "postal_code": "153708265",
            "telephone_number": "724-627-0926",
            "fax_number": "724-627-0812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "451 Murtha Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Waynesburg",
            "state": "PA",
            "postal_code": "153707010",
            "country_code": "US",
            "telephone_number": "724-852-6391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROADWATER",
        "first_name": "AMY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002774L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100772557-0020",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynda Bradley
• Amber Brancolini, D.M.D.
• Gretchen J Braun, CNM
• Charles Wesley Brice Jr., RPH
• Katelynn Marie Britenbaugh
• Hannah A Bross
• Melissa L Brown, OT
• Emily Joan Bryan, CRNP
• Tammy Filer Bryan, RPH
• Zachary Dennis Bryner

• Physician Assistant in Waynesburg, PA
• Providers in Waynesburg, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.