Active NPI
Amanda N Wilson, PA
- Physician Assistant
- Cheektowaga, NY
National Provider Identifier
1467826776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 018561
- Practice address
- 3884 Broadway St
Cheektowaga, NY 14227-1111 - Phone
- (716) 681-9000
- NPI assigned
- Nov 24, 2015
- Last updated
- May 2, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 018561 | NY | Primary |
Addresses
Primary practice location
3884 Broadway St
Cheektowaga, NY 14227-1111
Mailing address
3884 Broadway St
Cheektowaga, NY 14227-1111
Phone (716) 681-9000
Other practice location 1
1310 French Rd
Depew, NY 14043-4870
Phone (716) 668-2592
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8204874 | Other | NY | MVP |
| 8391586 | Other | NY | CIGNA |
Other names 1
- Amanda N Smith
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6255 Sheridan Dr
Williamsville, NY 14221-4825
Phone (716) 636-7979
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts, Physician Assistant
Interoperability endpoints
- awilson@highgatemedical.medentdirect.com
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.
-
- Family Medicine Physician
- Amherst, NY
- NPI 1326158593
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Millard Fillmore Suburban Hospital
- General Acute Care Hospital
- Williamsville, NY
- NPI 1053441907
-
dba Golisano Children's Hospital of Buffalo
- General Acute Care Hospital
- Buffalo, NY
- NPI 1245365196
-
- General Acute Care Hospital
- Buffalo, NY
- NPI 1366473183
-
dba Millard Fillmore Gates Hospital
- General Acute Care Hospital
- Buffalo, NY
- NPI 1831229780
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619913600000",
"number": "1467826776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3884 BROADWAY ST",
"city": "CHEEKTOWAGA",
"state": "NY",
"postal_code": "142271111",
"telephone_number": "716-681-9000",
"fax_number": "716-256-1079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3884 BROADWAY ST",
"city": "CHEEKTOWAGA",
"state": "NY",
"postal_code": "142271111",
"telephone_number": "716-681-9000"
}
],
"practiceLocations": [
{
"address_1": "1310 French Rd",
"address_purpose": "LOCATION",
"city": "Depew",
"state": "NY",
"postal_code": "140434870",
"country_code": "US",
"telephone_number": "716-668-2592",
"fax_number": "716-668-1383",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "AMANDA",
"middle_name": "N",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-24",
"last_updated": "2021-05-02",
"certification_date": "2021-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "018561",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "8204874",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "8391586",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "SMITH",
"middle_name": "N",
"credential": "PA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Cheektowaga, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.