Individual provider Active NPI

Amanda Marie Velazquez, PA-C

  • Surgical Physician Assistant
  • Arlington, WA
National Provider Identifier
1497454284
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA61450533 Issued in WA
Practice address
328 S Stillaguamish Ave
Arlington, WA 98223-1660
Phone
(360) 435-6097
Fax
(360) 435-1871
NPI assigned
Mar 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA61450533 WA Primary

Addresses

Primary practice location

328 S Stillaguamish Ave
Arlington, WA 98223-1660

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Other names 1

  • Amanda Marie Califf Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address avelazquez42106@skagit.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20230707002462 WA Practitioner - Physician Assistant 7618336736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone (360) 428-2500

1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone (360) 416-5750

330 S Stillaguamish Ave
Arlington, WA 98223-1642
Phone (360) 435-2133

Hospital & facility affiliations

  • Cascade Valley Hospital Hospital, Arlington, WA, CCN 500060
  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61450533WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Jul 17, 2023 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Jul 17, 2023 Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

328 S Stillaguamish Ave
Arlington, WA 98223
Phone (360) 435-2133

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

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 2

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": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1497454284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 S STILLAGUAMISH AVE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982231660",
            "telephone_number": "360-435-6097",
            "fax_number": "360-435-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61450533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avelazquez42106@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "328 S Stillaguamish Ave",
            "city": "Arlington",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982231660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "CALIFF",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arlington, WA

Sources for this page

Verify at the official NPI Registry.