Active NPI
Amanda Rose Phoenix, PHARM.D., BCACP, CDE
- Pharmacotherapy Pharmacist
- Bronx, NY
National Provider Identifier
1275081432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 061184
- Practice address
- 1650 Grand Concourse
Bronx, NY 10457-7606 - Phone
- (631) 835-3111
- NPI assigned
- Sep 16, 2016
- Last updated
- Nov 21, 2020
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 061184 | NY | |
| Pharmacotherapy Pharmacist | 1835P1200X | 061184 | NY | Primary |
| Ambulatory Care Pharmacist | 1835P2201X | 061184 | NY |
Addresses
Primary practice location
1650 Grand Concourse
Bronx, NY 10457-7606
Mailing address
56 Brook Manor LN
Pleasantville, NY 10570-2416
Phone (631) 835-3311
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05752314 | Medicaid | NY | |
| 05752534 | Medicaid | NY |
Other names 1
- Dr. Amanda Rose Maione
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 061184 | NY | MD | Ambulatory Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605916800000",
"number": "1275081432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 BROOK MANOR LN",
"city": "PLEASANTVILLE",
"state": "NY",
"postal_code": "105702416",
"telephone_number": "631-835-3311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104577606",
"telephone_number": "631-835-3111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHOENIX",
"first_name": "AMANDA",
"middle_name": "ROSE",
"name_prefix": "Dr.",
"credential": "PHARM.D., BCACP, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-16",
"last_updated": "2020-11-21",
"certification_date": "2020-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "061184",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "NY",
"license": "061184",
"primary": true
},
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "NY",
"license": "061184",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05752314",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05752534",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "MAIONE",
"middle_name": "ROSE",
"prefix": "DR.",
"credential": "PHARM.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.