Individual provider Active NPI

Amanda Janszen, PA-C

  • Physician Assistant
  • Dayton, OH
National Provider Identifier
1245050566
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.009022RX Issued in OH
Practice address
1 Wyoming St
Dayton, OH 45409-2711
Phone
(937) 208-8000
NPI assigned
Oct 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.009022RX OH Primary

Addresses

Primary practice location

1 Wyoming St
Dayton, OH 45409-2711

Mailing address

3737 Southern Blvd
Kettering, OH 45429-1262
Phone (937) 395-8601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241217001999 OH Practitioner - Physician Assistant 3971030818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722

1 Wyoming St
Berry Women'S Center Labor and Delivery
Dayton, OH 45409-2939
Phone (937) 439-4381

200 Medical Ctr Dr
Suite 325
Middletown, OH 45005-5178
Phone (937) 208-4200

30 E Apple St
Dayton, OH 45409-2939

450 N Hyatt St
Suite 304
Tipp City, OH 45371-1433
Phone (937) 832-4773

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.009022RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Jan 13, 2025 Accepting new patients
Premier Health Specialists Inc CurrentSince Jan 13, 2025 Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

30 E Apple St
Ste 5254A
Dayton, OH 45409

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

2300 Miami Valley Dr
Ste 550
Dayton, OH 45459
Phone (937) 438-7500

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

9000 N Main St
Ste 238
Englewood, OH 45415
Phone (937) 832-0006

200 Medical Center Dr
Ste 325
Middletown, OH 45005
Phone (513) 705-4762

3170 Kettering Blvd
Moraine, OH 45439
Phone (937) 208-6400

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

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.

Hospital & facility affiliations 3

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": "1728604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1245050566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291262",
            "telephone_number": "937-395-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092711",
            "telephone_number": "937-208-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSZEN",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-11",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.009022RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.