Individual provider Active NPI

Amanda Morgan Freeman, PA-C

  • Physician Assistant
  • Espanola, NM
National Provider Identifier
1427329077
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2024-0048 Issued in NM
Practice address
1010 Spruce St 2ND FL Area 3
Espanola, NM 87532-2724
Phone
(505) 367-0340
Fax
(505) 367-0346
NPI assigned
Jan 13, 2012
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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 PA2024-0048 NM Primary

Addresses

Primary practice location

1010 Spruce St 2ND FL Area 3
Espanola, NM 87532-2724

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 367-0340

Other identifiers 2

IdentifierTypeStateIssuer
926580507MedicaidMD
926580505MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130524000426 MD Practitioner - Physician Assistant 9931347374 Reassigns benefits to 2 organizations
I20240712001067 NM Practitioner - Physician Assistant 9931347374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

2200 W 21St St
Clovis, NM 88101-2011
Phone (505) 769-7577

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Menocal Medical Services PA Current Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 12, 2016 Accepting new patients
Presbyterian Healthcare Services CurrentSince Aug 12, 2024 Accepting new patients
Presbyterian Healthcare Services CurrentSince Aug 12, 2024 Accepting new patients
Privia Care Center LLC CurrentSince Oct 4, 2018 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 12, 2016 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

301 Saint Paul St
Ste 409
Baltimore, MD 21202
Phone (410) 659-7041

110 Baughmans Ln
Ste 140
Frederick, MD 21702
Phone (240) 215-1138

610 Solarex Ct
#2
Frederick, MD 21703

63 Thomas Johnson Dr
Ste E
Frederick, MD 21702
Phone (301) 687-7053

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

4588 Paradise Blvd NW
Albuquerque, NM 87114
Phone (505) 923-2070

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

1010 Spruce St
Espanola, NM 87532
Phone (505) 367-0340

1010 Spruce St
Fl 2
Espanola, NM 87532
Phone (505) 367-0340

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

Interoperability endpoints

  • Direct secure messaging: afreeman253873@direct.phs.org

Organizations & group practices 11

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": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1427329077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-367-0340",
            "fax_number": "505-367-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SPRUCE ST 2ND FL AREA 3",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322724",
            "telephone_number": "505-367-0340",
            "fax_number": "505-367-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "AMANDA",
        "middle_name": "MORGAN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2024-0048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926580507",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926580505",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Espanola, NM

Sources for this page

Verify at the official NPI Registry.