Individual provider Active NPI

Amanda Michelle Gicka, APRN, FNP-BC

  • Family Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1295378248
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11004322 Issued in FL
Practice address
2150 49TH St N Ste a
St Petersburg, FL 33710-5237
Phone
(727) 828-1730
Fax
(727) 828-1731
NPI assigned
Oct 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11004322 FL Primary

Addresses

Primary practice location

2150 49TH St N Ste a
St Petersburg, FL 33710-5237

Mailing address

2150 49TH St N Ste a
St Petersburg, FL 33710-5237
Phone (727) 828-1730

Other identifiers 1

IdentifierTypeStateIssuer
105036900MedicaidFL

Other names 1

  • Amanda Michelle Barrett Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200122002060 FL Practitioner - Nurse Practitioner 3678908597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

3328 49TH St N
St Petersburg, FL 33710-2101
Phone (727) 828-1730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11004322FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida LLC CurrentSince Feb 3, 2020 Accepting new patients
Optumcare Florida, LLC CurrentSince Feb 3, 2020 Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients

Locations

1989 W Lumsden Rd
Brandon, FL 33511
Phone (813) 653-3111

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

3328 49th St N
St Petersburg, FL 33710
Phone (727) 828-1730

2150 49th St N
Ste A
St Petersburg, FL 33710
Phone (727) 328-1841

10051 5th St N
Ste 200
St Petersburg, FL 33702
Phone (727) 286-4093

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: amanda.gicka@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1295378248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 49TH ST N STE A",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105237",
            "telephone_number": "727-828-1730",
            "fax_number": "727-828-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 49TH ST N STE A",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105237",
            "telephone_number": "727-828-1730",
            "fax_number": "727-828-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GICKA",
        "first_name": "AMANDA",
        "middle_name": "MICHELLE",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11004322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105036900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BARRETT",
            "middle_name": "MICHELLE",
            "credential": "APRN,FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.