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Individual provider Active NPI

Amanda Ober, MSN FNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1477036192
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP019490 Issued in PA
Practice address
1840 South Street
1St FL
Philadelphia, PA 19146-7411
Phone
(215) 893-6200
Fax
(215) 893-6215
NPI assigned
Sep 9, 2018
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X SP019490 PA
Family Nurse Practitioner 363LF0000X SP019490 PA Primary

Addresses

Primary practice location

1840 South Street
1St FL
Philadelphia, PA 19146-7411

Mailing address

800 Walnut Street
17TH Floor
Philadelphia, PA 19107-5109
Phone (215) 829-3523

Other names 1

  • Amanda Freidl Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181228001974 PA Practitioner - Nurse Practitioner 7214272830 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1840 S St
Suite 1
Philadelphia, PA 19146-7421
Phone (215) 893-6200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP019490PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
STC Pediatrics LLC Current Accepting new patients
STC Pediatrics LLC CurrentSince Dec 1, 2019 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince May 10, 2021 Accepting new patients
STC Pediatrics LLC CurrentSince Dec 1, 2019 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince May 10, 2021 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Current Accepting new patients

Locations

153 Brodhead Rd
Bethlehem, PA 18017
Phone (484) 526-3200

160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-5202

1840 South St
Ste 1
Philadelphia, PA 19146
Phone (215) 839-6200

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

800 Walnut St
Fl 16
Philadelphia, PA 19107
Phone (215) 829-0101

800 Walnut St
Fl 17
Philadelphia, PA 19107
Phone (215) 829-3016

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 6

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 5

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": "1536451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1477036192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WALNUT STREET",
            "address_2": "17TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075109",
            "telephone_number": "215-829-3523",
            "fax_number": "215-829-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 SOUTH STREET",
            "address_2": "1ST FL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191467411",
            "telephone_number": "215-893-6200",
            "fax_number": "215-893-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBER",
        "first_name": "AMANDA",
        "credential": "MSN FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-09",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP019490",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP019490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "FREIDL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.