Amanda Beth Tyburski

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP2174 Issued in ME

Practice address

800 Center St
Auburn, ME 04210-6404

Phone

(207) 782-2726

NPI assigned

Sep 5, 2011

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 names 1

• Amanda Beth Collette Former name

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Davis PT: a Balanced Approach, LLC

  • Physical Therapy Clinic/Center
  • Auburn, ME
  • NPI 1508427162
  Medicare reassignment NPD

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

{
    "created_epoch": "1315180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1326329368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 HERSEY HILL RD",
            "city": "MINOT",
            "state": "ME",
            "postal_code": "042584013",
            "telephone_number": "207-782-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 CENTER ST",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042106404",
            "telephone_number": "207-782-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYBURSKI",
        "first_name": "AMANDA",
        "middle_name": "BETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-05",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP2174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "COLLETTE",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Auburn, ME
• Providers in Auburn, ME by specialty
• Speech-Language Pathologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.