Amanda Marie Carrion, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

011530 Issued in NY

Practice address

113 Birch Rd
Kings Park, NY 11754-3234

Phone

(516) 403-3130

NPI assigned

Mar 16, 2007

Sex

Female

Sole proprietor

Yes

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Southwest Suffolk Medical, P.C.

  • Surgical Oncology Physician
  • Smithtown, NY
  • NPI 1104096049
  Medicare reassignment
• Southwest Suffolk Medical PC

  • Family Medicine Physician
  • Lindenhurst, NY
  • NPI 1770919763
  NPD
• Southwest Suffolk, P.C

  • Family Medicine Physician
  • Smithtown, NY
  • NPI 1730428467
  NPD
• Todd Mekles MD PC

  • Psychiatry Physician
  • New York, NY
  • NPI 1639050289
  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1467586735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 BIRCH RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117543234",
            "telephone_number": "516-403-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 BIRCH RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117543234",
            "telephone_number": "516-403-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRION",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "011530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Thomas Butcher, PHARMD
• Heather Butterworth, LMT
• Richelle Timtiman Cabanilla, PT
• Melissa Carrasquillo, OTR/L
• Jeffrey F Carrico, RN
• Linda Christina Carroll, R.N.
• Allison Cassata, CLC
• Castle Counseling LCSW PC
• Angela Teresa Cavallaro, LMHC
• Donna Maria Cavallo, PT, DPT

• Medical Physician Assistant in Kings Park, NY
• Providers in Kings Park, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.