Amanda Straub

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS017768 Issued in PA

Practice address

43 Servidea Dr
Ridgway, PA 15853-6333

Phone

(814) 776-2145

Fax

(814) 776-1470

NPI assigned

Dec 31, 2014

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

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dickinson Center, IncGroup PAC ID 3870489131, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dickinson Center, Inc

  • Community/Behavioral Health Agency
  • Ridgway, PA
  • NPI 1164503322
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1366830150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 SERVIDEA DR",
            "city": "RIDGWAY",
            "state": "PA",
            "postal_code": "158536333",
            "telephone_number": "814-776-2145",
            "fax_number": "814-776-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 SERVIDEA DR",
            "city": "RIDGWAY",
            "state": "PA",
            "postal_code": "158536333",
            "telephone_number": "814-776-2145",
            "fax_number": "814-776-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRAUB",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-31",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS017768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alissa Rose Shelander
• Joseph Edward Sherry, LCSW
• Bruce Roland Simons, PHD
• Sydney Jeanne Spang, PA-C
• Mark Charles Spiers, DMD
• Kylee Renee Streich, RN
• Narayana Subramany, M.D.
• Angela Marie Tassone, RN
• Troy Templeton, PA
• Cassie Titchner, LSW

• Psychologist in Ridgway, PA
• Providers in Ridgway, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; 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.