Alice Mustapha Amara, ACNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN229290 Issued in GA

Practice address

9250 W Thomas Rd
Suite 200
Phoenix, AZ 85037-3382

Phone

(623) 516-8252

Fax

(623) 516-8253

NPI assigned

Jan 17, 2012

Last updated

Nov 29, 2023By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physiatry Consultants of Ga LLCGroup PAC ID 5698182616, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Physiatry Consultants of Ga LLC

  • Physical Medicine & Rehabilitation Physician
  • Morton Grove, IL
  • NPI 1609468248

  GA

  Medicare reassignment Care Compare group NPD
• Brown Chiropractic and Wellness Center PC

  • Chiropractor
  • Cumming, GA
  • NPI 1518378744
  Medicare reassignment NPD
• Emory Medical Care Foundation Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1063452381

  Nurse Practitioner

  Medicare reassignment NPD
• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment NPD
• Brown Chiropractic Clinic PC

  • Medical Specialty Clinic/Center
  • Cumming, GA
  • NPI 1326223314
  NPD
• Emory Medical Care Foundation Inc

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1225294739
  NPD
• Cleaver Medical Group Dermatology Inc

  dba Cleaver Medical Group Dermatology

  • Dermatology Physician
  • Cumming, GA
  • NPI 1841852076
  NPD (past)

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1477824894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PROFESSIONAL PARK DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402381",
            "telephone_number": "623-241-6152",
            "fax_number": "623-241-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 W THOMAS RD",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373382",
            "telephone_number": "623-516-8252",
            "fax_number": "623-516-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMARA",
        "first_name": "ALICE",
        "middle_name": "MUSTAPHA",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-17",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN229290",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP4289",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z71338",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "687467",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Girardi
• Amanda Matje PA-C PLLC
• Amani Integrated Treatment Center LLC
• Iheanyi Nnamdi Amanwanne, NP PSYCH
• Surabhi Amar, M.D.
• Jason Zarahi Amaral, MD
• Meghan Amaral, COTA/L
• Amari Counseling PLLC
• Adam Thomas Amaro, RBT
• Laura Amato Yarbrough

• Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.

Verify at the official NPI Registry.