Individual provider Active NPI

Amy K Collins, P.A.-C

  • Physician Assistant
  • Port Huron, MI
National Provider Identifier
1417959487
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002811 Issued in MI
Practice address
940 River Centre Dr
Port Huron, MI 48060-4463
Phone
(810) 985-4900
Fax
(810) 985-3634
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601002811 MI Primary

Addresses

Primary practice location

940 River Centre Dr
Port Huron, MI 48060-4463

Mailing address

940 River Centre Dr
Port Huron, MI 48060-4463
Phone (810) 985-4900

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070713000136 MI Practitioner - Physician Assistant 6002703816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

940 River Centre Dr
Port Huron, MI 48060-4463
Phone (810) 985-4900

PO Box
Suite 5031
Port Huron, MI 48061-5031

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002811MIMDChiropractor
5601002811MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Associates of Port Huron PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AIIFDD

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.

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1417959487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 RIVER CENTRE DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604463",
            "telephone_number": "810-985-4900",
            "fax_number": "810-985-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 RIVER CENTRE DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604463",
            "telephone_number": "810-985-4900",
            "fax_number": "810-985-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "AMY",
        "middle_name": "K",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.