Active NPI
Amanda Lynn Gervasoni, DPM
- Podiatrist
- Farmington Hills, MI
National Provider Identifier
1265368948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 5951001628
- Practice address
- 28050 Grand River Ave
Farmington Hills, MI 48336-5919 - Phone
- (947) 521-8000
- NPI assigned
- Jun 22, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 5951001628 | MI | Primary |
Addresses
Primary practice location
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Mailing address
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Other names 1
- Amanda Lynn Roberts
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782086400000",
"number": "1265368948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28050 GRAND RIVER AVE",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483365919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28050 GRAND RIVER AVE",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483365919",
"telephone_number": "947-521-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERVASONI",
"first_name": "AMANDA",
"middle_name": "LYNN",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-06-22",
"last_updated": "2026-06-22",
"certification_date": "2026-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MI",
"license": "5951001628",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "ROBERTS",
"middle_name": "LYNN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.