NPIMap

Individual provider Active NPI

Amelia Stutman

  • Family Medicine Physician
  • Kotzebue, AK
National Provider Identifier
1487212437
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OT019023 Issued in PA
Practice address
436 5TH Avenue
Kotzebue, AK 99752-0161
Phone
(907) 442-3321
NPI assigned
Jun 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OT019023 PA Primary

Addresses

Primary practice location

436 5TH Avenue
Kotzebue, AK 99752-0161

Mailing address

436 5TH Avenue
Kotzebue, AK 99752-0161
Phone (907) 442-3321

Other identifiers 1

IdentifierTypeStateIssuer
OT019023MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250324000200 TX Practitioner - Family Practice 6406288752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maniilaq AssociationGroup PAC ID 6103881792, 32 clinicians

Practice addresses (Care Compare)

110 Main St
Ambler Clinic
Ambler, AK 99786-0110
Phone (907) 445-2129

436 5TH and Ted Stevens Way
Maniilaq Health Center
Kotzebue, AK 99752-0043
Phone (907) 442-3321

P O Box
Suite 43
Kotzubue, AK 99752-0043

PO Box
Suite 43
Kotzebue, AK 99752-0043

Hospital & facility affiliations

  • Maniilaq Health Center Hospital, Kotzebue, AK, CCN 021310
  • Alaska Native Medical Center Hospital, Anchorage, AK, CCN 020026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OT019023PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maniilaq Association CurrentSince Dec 29, 2024 Accepting new patients
Maniilaq Association Current Accepting new patients
Maniilaq Association CurrentSince Dec 29, 2024 Accepting new patients
Maniilaq Association Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: astutman@direct.maniilaq.org

Organizations & group practices 4

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.

Hospital & facility affiliations 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1487212437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 5TH AVENUE",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "997520161",
            "telephone_number": "907-442-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 5TH AVENUE",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "997520161",
            "telephone_number": "907-442-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTMAN",
        "first_name": "AMELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2023-12-01",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT019023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OT019023",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kotzebue, AK

Sources for this page

Verify at the official NPI Registry.