Individual provider Active NPI

Amanda Flohr, PA

  • Medical Physician Assistant
  • Pasadena, TX
National Provider Identifier
1205491594
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA17810 Issued in TX
Practice address
4102 Woodlawn Ave Ste 110
Pasadena, TX 77504-1948
Phone
(281) 784-9223
Fax
(281) 715-1802
NPI assigned
May 2, 2019
Last updated
Apr 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA17810 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

4102 Woodlawn Ave Ste 110
Pasadena, TX 77504-1948

Mailing address

4102 Woodlawn Ave Ste 110
Pasadena, TX 77504-1948
Phone (408) 674-6964

Other practice location 1

2415 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89052-2649
Phone (702) 434-8400

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250220002332 TX Practitioner - Physician Assistant 8224456397 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Medical Group, Inc. PastSince Jan 1, 2020 Accepting new patients

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": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1205491594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 WOODLAWN AVE STE 110",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041948",
            "telephone_number": "408-674-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 WOODLAWN AVE STE 110",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041948",
            "telephone_number": "281-784-9223",
            "fax_number": "281-715-1802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2415 W Horizon Ridge Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890522649",
            "country_code": "US",
            "telephone_number": "702-434-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLOHR",
        "first_name": "AMANDA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-02",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA17810",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.