Individual provider Active NPI

Amanda Irene Johnson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Grove City, PA
National Provider Identifier
1285123828
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC007161 Issued in PA
Practice address
647 N Broad Street Ext Ste 204
Grove City, PA 16127-4604
Phone
(724) 458-6245
Fax
(724) 458-6244
NPI assigned
May 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X SC007161 PA Primary

Addresses

Primary practice location

647 N Broad Street Ext Ste 204
Grove City, PA 16127-4604

Mailing address

PO Box 16008
Pittsburgh, PA 15242-0008
Phone (412) 929-0254

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210512000334 PA Practitioner - Podiatry 8820407414 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians
Delta Foot and Ankle Center, LLCGroup PAC ID 0547415135, 5 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

205 Hampton Ave
Punxsutawney, PA 15767-2133
Phone (814) 938-0148

742 N Broad St Ext
Grove City, PA 16127-4612
Phone (724) 458-6245

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.17 of 100Reported as group
Quality
70.35
Improvement activities
40
Cost
87.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue55
Removal of nail tissue872
Removal or shaving of skin growth255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC007161PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gary a Raymond, DPM PC Foot & Ankle Surgery CurrentSince Jul 1, 2021 Accepting new patients
Delta Foot and Ankle Center, LLC Foot & Ankle Surgery CurrentSince Jan 1, 2024 Accepting new patients
Gary a Raymond, DPM, PC Foot & Ankle Surgery CurrentSince Jul 1, 2021 Accepting new patients
Brian Szabo,DPM,PC PastSince Sep 18, 2008 Accepting new patients

Locations

711 Logan Blvd
Altoona, PA 16602

801 E Dubois Ave
Dubois, PA 15801
Phone (814) 375-8882

310 State Route 288
Ellwood City, PA 16117
Phone (724) 274-8484

647 N Broad Street Ext
Ste 204
Grove City, PA 16127
Phone (724) 458-6245

435 N Broad St
Grove City, PA 16127
Phone (724) 450-7800

742 N Broad Street Ext
Grove City, PA 16127
Phone (724) 458-6245

647 N Broad Street Ext
Grove City, PA 16127
Phone (724) 450-7004

2501 Shenango Valley Fwy
Ste 2
Hermitage, PA 16148
Phone (724) 458-6245

1906 Wilmington Rd
Ste 5
New Castle, PA 16105
Phone (724) 654-3182

244 N Findley St
Punxsutawney, PA 15767
Phone (814) 938-1770

763 Johnsonburg Rd
Saint Marys, PA 15857
Phone (814) 788-8000

2590 Park Center Blvd
Ste 200
State College, PA 16801
Phone (814) 231-1566

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 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1285123828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16008",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152420008",
            "telephone_number": "412-929-0254",
            "fax_number": "412-920-5861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 N BROAD STREET EXT STE 204",
            "city": "GROVE CITY",
            "state": "PA",
            "postal_code": "161274604",
            "telephone_number": "724-458-6245",
            "fax_number": "724-458-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMANDA",
        "middle_name": "IRENE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC007161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove City, PA

Sources for this page

Verify at the official NPI Registry.