Amanda M Mastrofini, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704288346 Issued in MI

Practice address

3577 W 13 Mile Rd Ste 204
Royal Oak, MI 48073-6710

Phone

(248) 551-2446

Fax

(248) 551-1094

NPI assigned

Sep 19, 2018

Last updated

Dec 18, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians

University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297
• Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amastrofini1245556@epic00.shdirect.org
• Direct secure messaging: amastrofini597899@direct.hfhs.org

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.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment Care Compare group NPD
• University Physician Group

  dba Wayne Health

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797
  Medicare reassignment Care Compare group NPD
• Barbara Ann Karmanos Cancer Institute

  • Mammography Clinic/Center
  • Detroit, MI
  • NPI 1225022288
  Medicare reassignment NPD
• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547
  Medicare reassignment NPD
• Barbara Ann Karmanos Cancer Institute

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Detroit, MI
  • NPI 1386060226
  NPD
• Michigan Healthcare Professionals PC

  dba Urology Specialist of Michigan

  • Durable Medical Equipment & Medical Supplies
  • Lapeer, MI
  • NPI 1992693303
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Barbara Ann Karmanos Cancer Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1316900277
  Care Compare affiliation
• Oakwood Healthcare Inc

  dba Beaumont Outpatient Diabetes Education

  • Community Health Clinic/Center
  • Dearborn, MI
  • NPI 1790414670

  Hospital

  Care Compare affiliation
• Oakwood Healthcare, Inc.

  dba Beaumont Hospital - Dearborn

  • General Acute Care Hospital
  • Dearborn, MI
  • NPI 1740230119
  Care Compare affiliation

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1285118919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29992 NORTHWESTERN HWY STE C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343292",
            "telephone_number": "248-851-1430",
            "fax_number": "248-851-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3577 W 13 MILE RD STE 204",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736710",
            "telephone_number": "248-551-2446",
            "fax_number": "248-551-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTROFINI",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704288346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4704288346",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285118919",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "MI4989654",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen Mason, MD
• Roxanne Massad, FNP
• Maria C Massos, LLMSW
• Sean Elliot Masters, MD
• Marie Terese Mastracci
• Kenneth Matasar
• Meghan Nicole Matekel, PA-C
• Jinu M Mathew, DPT
• Maryam Samir Yousif Matloub
• Matt Sweet MSW PC

• Gerontology Nurse Practitioner in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.