Amanda Christine Packo, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN.CRNA.17032 Issued in OH

Practice address

1044 Belmont Ave
Youngstown, OH 44504-1006

Phone

(330) 480-3658

Fax

(330) 480-3439

NPI assigned

Jan 29, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bel-Park Anesthesia Associates, Inc.Group PAC ID 8628974904, 158 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Bel-Park Anesthesia Associates, Inc.

  • Anesthesiology Physician
  • Youngstown, OH
  • NPI 1508813528

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Northstar Anesthesia of Ohio LLC

  • Anesthesiology Physician
  • Springfield, OH
  • NPI 1417276429
  Medicare reassignment NPD

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1316337348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 BOARDMAN CANFIELD RD STE 101",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069803",
            "telephone_number": "330-286-5330",
            "fax_number": "330-286-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041006",
            "telephone_number": "330-480-3658",
            "fax_number": "330-480-3439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8401 Market St",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445126725",
            "country_code": "US",
            "telephone_number": "330-729-2929",
            "fax_number": "330-286-5396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACKO",
        "first_name": "AMANDA",
        "middle_name": "CHRISTINE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-29",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN342265COA1",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.17032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000912918",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PTAN",
            "identifier": "P02076614",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13547104",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0117817",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H435190",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan E. Owens, LCDCIII, QMHS
• Teddy Owens
• Casey Owsley
• P. Y. Solanki, M.D., Inc.
• Brian P Pachell, QMHS
• Kathleen S Padgitt, M.D.
• Apurva Padubidri, M.D.
• Joi A Pagan, RN
• Barbara Anne Pagani, LPCC
• Antonio Deon Page

• Certified Registered Nurse Anesthetist in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.