Individual provider Active NPI

Amanda Grace Vierling, PA-C

  • Physician Assistant
  • East Patchogue, NY
National Provider Identifier
1407501265
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027644 Issued in NY
Practice address
285 Sills Rd BLDG 18
East Patchogue, NY 11772-4808
Phone
(631) 475-1224
Fax
(631) 475-1588
NPI assigned
Feb 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 027644 NY
Physician Assistant 363A00000X 027644 NY Primary

Addresses

Primary practice location

285 Sills Rd BLDG 18
East Patchogue, NY 11772-4808

Mailing address

285 Sills Rd BLDG 18
East Patchogue, NY 11772-4808
Phone (631) 475-1224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220412001912 NY Practitioner - Physician Assistant 6103212592 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

715 Roanoke Ave
Riverhead, NY 11901-2769
Phone (516) 541-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
027644NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 31, 2023 Accepting new patients
New York University CurrentSince Jul 31, 2023 Accepting new patients
Orthopedic Assoc of Long Island Physicians & Medical Group PLLC CurrentSince Dec 12, 2022 Accepting new patients
Orthopedic Assoc of Long Island Physicians & Medical Group PLLC CurrentSince Dec 12, 2022 Accepting new patients

Locations

285 Sills Rd
Bldg 18
East Patchogue, NY 11772
Phone (631) 475-1241

6 Technology Dr
Ste 100
East Setauket, NY 11733
Phone (631) 371-2685

715 Roanoke Ave
Ste 4
Riverhead, NY 11901
Phone (631) 963-4760

2500 Nesconset Hwy
Bldg 20A
Stony Brook, NY 11790
Phone (631) 246-6100

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1645228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1407501265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SILLS RD BLDG 18",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724808",
            "telephone_number": "631-475-1224",
            "fax_number": "631-475-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SILLS RD BLDG 18",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724808",
            "telephone_number": "631-475-1224",
            "fax_number": "631-475-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIERLING",
        "first_name": "AMANDA",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-19",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "027644",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

Verify at the official NPI Registry.