Amanda R Goddard, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2009018151 Issued in MO

Practice address

3808 S Greystone CT
Springfield, MO 65804-6561

Phone

(417) 889-3332

Fax

(417) 881-1410

NPI assigned

Jul 9, 2009

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 identifiers 3

Other names 1

• Amanda R Bargo Former name

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cornerstone Dermatology and Surgery Group PCGroup PAC ID 3870856669, 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.09 of 100Reported as group

Quality

91.65

Improvement activities

40

Cost

68.1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abargo133594@directb.mercy.net

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.

• Cornerstone Dermatology & Surgery Group, PC

  • Procedural Dermatology Physician
  • Lee's Summit, MO
  • NPI 1114427739
  Medicare reassignment Care Compare group
• Jenifer Insley MD LLC

  • Dermatology Physician
  • Springfield, MO
  • NPI 1649793076
  NPD
• Raffaele Pennella MD LLC

  • Dermatopathology Physician
  • Springfield, MO
  • NPI 1568992782
  NPD

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1356570576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 S GREYSTONE CT",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046561",
            "telephone_number": "417-889-3332",
            "fax_number": "417-881-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 S GREYSTONE CT",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046561",
            "telephone_number": "417-889-3332",
            "fax_number": "417-881-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "AMANDA",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-09",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2009018151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431560263",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00985991",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BLUECROSS/BLUE SHIELD",
            "identifier": "8P159",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BARGO",
            "middle_name": "R",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Muriel Tania Luy Go, M.D., M.B.A.
• Alyson Leigh Goad, AU.D
• Phillip Wayne Goble, PT, CHT
• James L Godard, DO
• Jessica K Godby
• Kylee Goddard, OD
• Bobbi Michele Godfrey, MSW, LCSW
• Lehman W Godwin, MD
• Sarah Diane Goetz
• Erika Dawn Goetzinger, NP

• Physician Assistant in Springfield, MO
• Providers in Springfield, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.