Individual provider Active NPI

Amy K Nielsen, D.O.

  • Surgery Physician
  • Escanaba, MI
National Provider Identifier
1356736995
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5101025626 Issued in MI
Practice address
2525 5TH Ave S
Escanaba, MI 49829
Phone
(906) 233-4190
Fax
(906) 789-3479
NPI assigned
Mar 31, 2015
Last updated
Mar 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5101025626 MI Primary

Addresses

Primary practice location

2525 5TH Ave S
Escanaba, MI 49829

Mailing address

2525 5TH Ave S
Escanaba, MI 49829
Phone (906) 233-4190

Other identifiers 1

IdentifierTypeStateIssuer
1356736995MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200928002153 MI Practitioner - General Surgery 5496057655 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Midwestern University, Chicago College of Osteopathic Med, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1400 W Ice Lake Rd
Iron River, MI 49935-9526
Phone (906) 265-6121

814 S Ice Lake Rd
Aspirus Iron River Clinic
Iron River, MI 49935-9481
Phone (906) 265-0499

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101025626MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Keweenaw CurrentSince Jan 1, 2024 Accepting new patients
Aspirus Keweenaw Current Accepting new patients
Aspirus Iron River Hospital & Clinics, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Aspirus Keweenaw CurrentSince Jan 1, 2024 Accepting new patients
Aspirus Iron River Hospital & Clinics, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Osf Multi-Specialty Group CurrentSince Oct 5, 2020 Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

2525 5th Ave S
Escanaba, MI 49829
Phone (906) 233-4276

3409 Ludington St
Ste 206
Escanaba, MI 49829
Phone (906) 786-7471

1000 Cedar St
Houghton, MI 49931
Phone (906) 482-8201

1400 W Ice Lake Rd
Iron River, MI 49935
Phone (906) 265-6121

814 S Ice Lake Rd
Iron River, MI 49935
Phone (715) 847-2022

N10561 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

N10565 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

205 Osceola St
Laurium, MI 49913
Phone (906) 337-3100

Interoperability endpoints

  • Direct secure messaging: amynielsen@normd.allscriptsdirect.net
  • Direct secure messaging: anielsen213957@direct.aspirus.org

Organizations & group practices 9

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 2

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": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1356736995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 5TH AVE S",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "49829",
            "telephone_number": "906-233-4190",
            "fax_number": "906-789-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 5TH AVE S",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "49829",
            "telephone_number": "906-233-4190",
            "fax_number": "906-789-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "AMY",
        "middle_name": "K",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101025626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356736995",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

Verify at the official NPI Registry.