Individual provider Active NPI

Amanda E Bohleber, M.D.

  • Family Medicine Physician
  • Evansville, IN
National Provider Identifier
1306981394
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01064351A Issued in IN
Practice address
520 Mary St
Ste 340
Evansville, IN 47710-1677
Phone
(812) 450-6700
Fax
(812) 450-6710
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01064351A IN Primary

Addresses

Primary practice location

520 Mary St
Ste 340
Evansville, IN 47710-1677

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 450-6700

Other identifiers 1

IdentifierTypeStateIssuer
200907080MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080821000459 IN Practitioner - Family Practice 0345315560 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

421 Chestnut St
Evansville, IN 47713-1227
Phone (812) 426-6645

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01064351AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Specialty Physicians, Inc Current Accepting new patients
Deaconess Specialty Physicians Inc Family Medicine CurrentSince Sep 12, 2024 Accepting new patients
Deaconess Speciality Physicians, Inc CurrentSince Sep 12, 2024 Accepting new patients
Deaconess Clinic Inc Family Medicine CurrentSince Oct 1, 2008 Accepting new patients
Deaconess Clinic Inc. Current Accepting new patients
Deaconess Clinic Inc Family Medicine CurrentSince Oct 1, 2008 Accepting new patients

Locations

520 Mary St
Ste 340
Evansville, IN 47710
Phone (812) 450-3201

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4015 Gateway Blvd
Ste 2120
Newburgh, IN 47630
Phone (812) 492-5457

4015 Gateway Blvd
Newburgh, IN 47630
Phone (812) 858-6244

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

Interoperability endpoints

  • Direct secure messaging: abohleber1694@direct.deaconess.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Deaconess Clinic IPetersburg, IN, CCN 153843 Rural health clinic Corporate Director Oct 1, 2012

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1306981394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-450-6700",
            "fax_number": "812-450-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MARY ST",
            "address_2": "STE 340",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101677",
            "telephone_number": "812-450-6700",
            "fax_number": "812-450-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHLEBER",
        "first_name": "AMANDA",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01064351A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200907080",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.