Individual provider Active NPI

Amanda Clonick, NP

  • Adult Health Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1235827494
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F311119 Issued in NY
Practice address
2400 S Clinton Ave Ste 230
Rochester, NY 14618-2668
Phone
(585) 341-7220
NPI assigned
Apr 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F311119 NY Primary

Addresses

Primary practice location

2400 S Clinton Ave Ste 230
Rochester, NY 14618-2668

Mailing address

136 Crystal Creek Dr
Rochester, NY 14612-3074
Phone (585) 880-3782

Other names 1

  • Amanda Hauer Former name

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
I20230530001418 NY Practitioner - Nurse Practitioner 9537526017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

2400 Clinton S Ave H
Rochester, NY 14618-2668
Phone (585) 341-7143

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F311119NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Jul 10, 2023 Accepting new patients
University of Rochester CurrentSince Jul 10, 2023 Accepting new patients
University of Rochester PastSince Apr 30, 2023 Accepting new patients

Locations

2400 S Clinton Ave
#H
Rochester, NY 14618
Phone (585) 341-7299

2400 S Clinton Ave
Ste H230
Rochester, NY 14618
Phone (585) 341-7200

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1235827494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 CRYSTAL CREEK DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146123074",
            "telephone_number": "585-880-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S CLINTON AVE STE 230",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182668",
            "telephone_number": "585-341-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLONICK",
        "first_name": "AMANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F311119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "HAUER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.