Individual provider Active NPI

Amanda Lynn Alberding, ANP

  • Family Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1346597630
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71004064A Issued in IN
Practice address
211 N Eddy St
South Bend, IN 46617-3096
Phone
(574) 237-9231
NPI assigned
Aug 6, 2012
Last updated
Apr 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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 71004064A IN Primary

Addresses

Primary practice location

211 N Eddy St
South Bend, IN 46617-3096

Mailing address

211 N Eddy St
South Bend, IN 46617-2808
Phone (574) 237-9231

Other identifiers 1

IdentifierTypeStateIssuer
201230300MedicaidIN

Other names 1

  • Amanda Lynn Aust Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120919000747 IN Practitioner - Nurse Practitioner 4981852738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Dermatology Institute, LLCGroup PAC ID 7911043054, 51 clinicians

Practice addresses (Care Compare)

1550 S Woodland Ave
Michigan City, IN 46360-7125
Phone (219) 878-5020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71004064AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Applegarth Dermatology PC CurrentSince Jun 1, 2004 Accepting new patients
Illinois Dermatology Institute, LLC CurrentSince Nov 9, 2022 Accepting new patients
Northern Indiana Dermatology and Skin Surgery Center Past Accepting new patients
Applegarth Dermatology PC Past Accepting new patients

Locations

2622 Momentum Pl
Chicago, IL 60689

1550 S Woodland Ave
Michigan City, IN 46360
Phone (219) 878-5020

3190 Lancer St
Portage, IN 46368
Phone (219) 764-3600

1861 Sturdy Rd
Valparaiso, IN 46383
Phone (219) 548-0360

Interoperability endpoints

  • Direct secure messaging: aalberding@illinois.emadirect.md

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1346597630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172808",
            "telephone_number": "574-237-9231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173096",
            "telephone_number": "574-237-9231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBERDING",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-06",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004064A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201230300",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "AUST",
            "middle_name": "LYNN",
            "credential": "ANP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.