Individual provider Active NPI

Amy Eleanora Mauritson, MD

  • Internal Medicine Physician
  • Germantown, TN
National Provider Identifier
1205153863
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
49495 Issued in TN
Practice address
7691 Poplar Ave
Germantown, TN 38138-3904
Phone
(901) 516-1290
Fax
(901) 516-1220
NPI assigned
Apr 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 49495 TN
Internal Medicine Physician 207R00000X 49495 TN Primary

Addresses

Primary practice location

7691 Poplar Ave
Germantown, TN 38138-3904

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Other practice location 1

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (901) 516-1290

Other identifiers 5

IdentifierTypeStateIssuer
4356030OtherTNBCBS
05408516MedicaidMS
199592001MedicaidAR
Q004417MedicaidTN
P01277319OtherTNRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130830000077 TN Practitioner - HospitalistPractitioner - Internal Medicine 0345488284 Reassigns benefits to 1 organization
I20150212000583 MS Practitioner - HospitalistPractitioner - Internal Medicine 0345488284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of Tennessee, HSC, College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Inpatient Physicians LLCGroup PAC ID 1254241235, 123 clinicians

Practice addresses (Care Compare)

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (901) 516-1290

7691 Poplar Ave
Germantown, TN 38138-3904
Phone (901) 516-1290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49495TNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Inpatient Physicians LLC Internal Medicine CurrentSince Jan 1, 2017 Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients

Locations

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

1211 Union Ave
Ste 700
Memphis, TN 38104
Phone (901) 287-5182

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

Interoperability endpoints

  • Direct secure messaging: amauritson22519@mlh.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1271894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1205153863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7691 POPLAR AVE",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383904",
            "telephone_number": "901-516-1290",
            "fax_number": "901-516-1220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4250 Bethel Rd",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386548737",
            "country_code": "US",
            "telephone_number": "901-516-1290",
            "fax_number": "901-516-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAURITSON",
        "first_name": "AMY",
        "middle_name": "ELEANORA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-22",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "49495",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "49495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4356030",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05408516",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199592001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q004417",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01277319",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.