Individual provider Active NPI

Amanda A Burr, PA

  • Medical Physician Assistant
  • Johnston, RI
National Provider Identifier
1265665319
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA3824 Issued in MA
Practice address
1524 Atwood Ave
Suite 220
Johnston, RI 02919-3228
Phone
(401) 272-1900
Fax
(401) 453-3049
NPI assigned
Aug 24, 2009
Last updated
Mar 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA3824 MA Primary

Addresses

Primary practice location

1524 Atwood Ave
Suite 220
Johnston, RI 02919-3228

Mailing address

1524 Atwood Ave
Suite 220
Johnston, RI 02919-3228
Phone (401) 272-1900

Other identifiers 1

IdentifierTypeStateIssuer
PA3824OtherMAMASSACHUSETTS LIC #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20101222000372 RI Practitioner - Physician Assistant 6800084500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Atwood Medical Associates LTDGroup PAC ID 0941106652, 24 clinicians

Practice addresses (Care Compare)

1524 Atwood Ave
Johnston, RI 02919-3288
Phone (401) 272-1900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA3824MAMDMedical Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1265665319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 ATWOOD AVE",
            "address_2": "SUITE 220",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193228",
            "telephone_number": "401-272-1900",
            "fax_number": "401-453-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 ATWOOD AVE",
            "address_2": "SUITE 220",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193228",
            "telephone_number": "401-272-1900",
            "fax_number": "401-453-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURR",
        "first_name": "AMANDA",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA3824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSACHUSETTS LIC #",
            "identifier": "PA3824",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, RI

Sources for this page

Verify at the official NPI Registry.