Active NPI
Amanda Gayle Cooke, M.D.
- Internal Medicine Physician
- Boston, MA
National Provider Identifier
1356755607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 270105
- Practice address
- 330 Brookline Ave
Boston, MA 02215-5400 - Phone
- (617) 667-7000
- NPI assigned
- Jun 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 326635 | LA | |
| Internal Medicine Physician | 207R00000X | A167923 | CA | |
| Internal Medicine Physician | 207R00000X | 270105 | MA | Primary |
Addresses
Primary practice location
330 Brookline Ave
Boston, MA 02215-5400
Mailing address
2000 Canal St
New Orleans, LA 70112-3018
Phone (504) 702-5554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A167923 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Administrators of the Tulane Educational Fund | Current | Accepting new patients | |
| Administrators of the Tulane Educational Fund | Current | Accepting new patients |
Locations
4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028
1430 Tulane Ave
#8016
New Orleans, LA 70112
Phone (504) 988-1332
2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287
1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300
Organizations & group practices 2
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.
-
- Specialist
- New Orleans, LA
- NPI 1528014164
-
- Specialist
- Hattiesburg, MS
- NPI 1033395298
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648425600000",
"number": "1356755607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 CANAL ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701123018",
"telephone_number": "504-702-5554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 BROOKLINE AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155400",
"telephone_number": "617-667-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOKE",
"first_name": "AMANDA",
"middle_name": "GAYLE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-15",
"last_updated": "2022-03-28",
"certification_date": "2020-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "LA",
"license": "326635",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A167923",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "270105",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.