Individual provider Active NPI

Amanda P Sifuentes-Smith, PA-C

  • Physician Assistant
  • Dubuque, IA
National Provider Identifier
1417779968
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
250 Mercy Dr
Dubuque, IA 52001-7320
Phone
(563) 589-9666
NPI assigned
Oct 28, 2024
Last updated
Feb 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

250 Mercy Dr
Dubuque, IA 52001-7320

Mailing address

2000 University Ave
Dubuque, IA 52001-5099
Phone (563) 589-3662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20260311002245 IA Practitioner - Physician Assistant 5698258549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dubuque Emergency Physicians PCGroup PAC ID 9032001797, 10 clinicians

Practice addresses (Care Compare)

250 Mercy Dr
Dubuque, IA 52001-7320
Phone (319) 589-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
136496IAMDHemodialysis Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dubuque Emergency Physicians PC CurrentSince Jan 12, 2026 Accepting new patients

Locations

250 Mercy Dr
Dubuque, IA 52001
Phone (563) 589-8000

Organizations & group practices 1

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 1

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": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1417779968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 UNIVERSITY AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520015099",
            "telephone_number": "563-589-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MERCY DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520017320",
            "telephone_number": "563-589-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIFUENTES-SMITH",
        "first_name": "AMANDA",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-28",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.