Individual provider Active NPI

Amanda Loitsch

  • Psychiatric/Mental Health Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1205563426
Registry record updated Aug 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
404317 Issued in NY
Practice address
1860 South Ave
Rochester, NY 14620-4229
Phone
(585) 273-1776
NPI assigned
Aug 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 404317 NY Primary

Addresses

Primary practice location

1860 South Ave
Rochester, NY 14620-4229

Mailing address

1860 South Ave
Rochester, NY 14620-4229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230310001908 NY Practitioner - Nurse Practitioner 6507235256 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
404317NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Dec 7, 2022 Accepting new patients
University of Rochester CurrentSince Dec 7, 2022 Accepting new patients
Penfield Psychiatry PC CurrentSince Oct 10, 2024 Accepting new patients
University of Rochester Current Accepting new patients

Locations

2060 Fairport Nine Mile Point Rd
Ste 400
Penfield, NY 14526
Phone (585) 388-6000

481 Penbrooke Dr
Ste 6
Penfield, NY 14526
Phone (585) 388-1110

601 Elmwood Ave
#684
Rochester, NY 14642
Phone (585) 784-9503

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Organizations & group practices 4

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": "1659830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659830400000",
    "number": "1205563426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 SOUTH AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 SOUTH AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204229",
            "telephone_number": "585-273-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOITSCH",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-07",
        "last_updated": "2022-08-07",
        "certification_date": "2022-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.