Amanda Gostigian, DO

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

125081875 Issued in IL

Practice address

800 E Carpenter Street Box 43
Springfield, IL 62769-4968

Phone

(217) 814-5178

Fax

(217) 757-6458

NPI assigned

Aug 24, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Physician Assistant

State licenses

Practice roles

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.

• Lee Memorial Health System

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
  • NPI 1720715295
  NPD

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1467907006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER STREET BOX 43",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627690001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER STREET BOX 43",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627694968",
            "telephone_number": "217-814-5178",
            "fax_number": "217-757-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSTIGIAN",
        "first_name": "AMANDA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125081875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Goodwin
• Alex Gorbonos, M.D.
• Carol A Gorden, CRNA
• Jessica A Gorsek, APRN
• Nicholas Anthony Goska, DO
• Jennifer Colleen Gostowski, LCSW
• Gottrich Counseling and Consulting Services PC
• Kay A. Gottrich, LCPC
• Ronald W. Gottrich, R.PH., M.S.
• Aaron P Gould, MD

• Diagnostic Radiology Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.