Jeffrey L Amodeo, M.D.
Individual provider Active NPI Surgery Physician · Martinsville, IN
NPI 1346239571 · NPPES record last updated Apr 5, 2012
Key facts
- NPI
- 1346239571
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 01068850A (IN)
- Practice address
- 2200 John R Wooden Dr
Martinsville, IN 46151-1863 - Phone
- (765) 342-5415
- Fax
- (765) 342-3415
- NPI assigned
- Oct 20, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01068850A | IN | MD | Surgery Physician |
| 234562 | NY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morgan Health Services, Inc | Past | Accepting new patients | |
| Frontier Surgical Associates, LLP | Surgery | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 234562 | NY | |
| Surgery Physician | 208600000X | 01068850A | IN | Yes |
Addresses
Primary practice location
2200 John R Wooden Dr
Martinsville, IN 46151-1863
Mailing address
PO Box 1557
Martinsville, IN 46151-0557
Phone (765) 349-4600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02656499 | Medicaid | NY | |
| 1712914 | Other | NY | IHA |
| 01068850A | Other | IN | IN STATE LICENSE |
| 164405FL | Other | NY | PREFERRED CARE |
| 050802000019 | Other | NY | FIDELIS |
| 000528151001 | Other | NY | BC/BS |
| 00027200501 | Other | NY | UNIVERA |
Other providers in Martinsville, IN
- Lynn Achenbach
- Cynthia Sue Addie
- Joel Ales
- Allabout Chiropractic Care
- Mitch Allard
- Amourtransport
- Amy Anderson
- Chasity Rae Anderson
- Kathy Andrade
- Emilee Anne Arens
All providers in Martinsville, IN · Surgery Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.