Individual provider Active NPI

Amanda J Tvedt, DPT

  • Physical Therapist
  • Tucson, AZ
National Provider Identifier
1194753822
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-007670 Issued in AZ
Practice address
5956 E Pima St Ste 100
Tucson, AZ 85712-4375
Phone
(520) 885-4636
Fax
(520) 885-4736
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X LPT-007670 AZ Primary
Physical Therapist 225100000X PT29677 CA

Addresses

Primary practice location

5956 E Pima St Ste 100
Tucson, AZ 85712-4375

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980

Other names 1

  • Miss Amanda J Ravenscroft Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070613000138 AZ Practitioner - Physical Therapist in Private Practice 4587628847 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians
Modern Sports Medicine LLCGroup PAC ID 6800228479, 40 clinicians

Practice addresses (Care Compare)

5956 E Pima St
Suite 100
Tucson, AZ 85712-4375
Phone (520) 885-4636

6606 E Carondelet Dr
Tucson, AZ 85710-2119
Phone (480) 306-6627

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-007670AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jul 8, 2024 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jul 8, 2024 Accepting new patients
San Luis Physical Therapy & Orthopedic Rehabilitation Inc Physical Therapist Past Accepting new patients
San Luis Physical Therapy & Orthopedic Rehabilitation Inc Physical Therapist Past Accepting new patients

Locations

6070 W Bell Rd
Ste A103
Glendale, AZ 85308
Phone (602) 782-3965

8270 S Houghton Rd
Ste 180
Tucson, AZ 85747
Phone (520) 664-1430

6970 N Oracle Rd
Ste 130
Tucson, AZ 85704
Phone (520) 219-5825

5956 E Pima St
Ste 100
Tucson, AZ 85712
Phone (520) 855-4636

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

Interoperability endpoints

  • Direct secure messaging: amanda.tvedt.p6@direct.athleticoltd.nextgenshare.com

Organizations & group practices 5

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1194753822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5956 E PIMA ST STE 100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857124375",
            "telephone_number": "520-885-4636",
            "fax_number": "520-885-4736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TVEDT",
        "first_name": "AMANDA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-007670",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT29677",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "RAVENSCROFT",
            "middle_name": "J",
            "prefix": "MISS",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.