Individual provider Active NPI

Amanda Maria Cason Shandor, FNP-BC

  • Family Nurse Practitioner
  • Harrisburg, PA
National Provider Identifier
1255754164
Registry record updated Dec 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP021530 Issued in PA
Practice address
4310 Londonderry Rd Ste 109
Harrisburg, PA 17109-5329
Phone
(717) 988-0611
NPI assigned
Jan 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A005638 AR
Family Nurse Practitioner 363LF0000X SP021530 PA Primary

Addresses

Primary practice location

4310 Londonderry Rd Ste 109
Harrisburg, PA 17109-5329

Mailing address

4310 Londonderry Rd Ste 109
Harrisburg, PA 17109-5329
Phone (717) 614-4420

Other practice location 1

4111 W Mitchell St
Milwaukee, WI 53215-1748
Phone (414) 385-8800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ashandor171361@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200413002268 PA Practitioner - Nurse Practitioner 9537390455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

4310 Londonderry Rd
Harrisburg, PA 17109-5300
Phone (717) 988-0611

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.08 of 100Reported as group
Quality
76.48
Promoting interoperability
100
Improvement activities
40
Cost
77.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A005638ARMDFamily Nurse Practitioner
SP021530PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Apr 2, 2020 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients
Pinnacle Health Medical Services CurrentSince Apr 2, 2020 Accepting new patients
Pinnacle Health Medical Services Past Accepting new patients

Locations

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

4310 Londonderry Rd
Ste 109
Harrisburg, PA 17109
Phone (717) 614-4420

2025 Technology Pkwy
Ste 207
Mechanicsburg, PA 17050
Phone (717) 791-2560

2020 Technology Pkwy
Ste 3200
Mechanicsburg, PA 17050
Phone (717) 988-1428

Interoperability endpoints

  • Direct secure messaging: ashandor514506@upmc.direct-ci.com

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 7

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": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607731200000",
    "number": "1255754164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 LONDONDERRY RD STE 109",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095329",
            "telephone_number": "717-614-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 LONDONDERRY RD STE 109",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095329",
            "telephone_number": "717-988-0611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4111 W Mitchell St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532151748",
            "country_code": "US",
            "telephone_number": "414-385-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANDOR",
        "first_name": "AMANDA",
        "middle_name": "MARIA CASON",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-28",
        "last_updated": "2020-12-12",
        "certification_date": "2020-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005638",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP021530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashandor171361@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "4310 Londonderry Rd Ste 109",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171095329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.