Individual provider Active NPI

Amanda Hernandez, RN, CRNP

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1497551121
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP032501 Issued in PA
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-0958
NPI assigned
Feb 24, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP032501 PA Primary
Family Nurse Practitioner 363LF0000X R228228 MD

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

30 Monument Rd Ste 1100
York, PA 17403-5024
Phone (717) 851-2441

Other names 1

  • Amanda Theiller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250609000975 PA Practitioner - Nurse Practitioner 1557871662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

30 Monument Rd
Suite 1100
York, PA 17403-5024
Phone (717) 851-6454

Hospital & facility affiliations

  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R228228MDMDFamily Nurse Practitioner
SP032501PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Jul 14, 2025 Accepting new patients
Wellspan Medical Group CurrentSince Jul 14, 2025 Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

30 Monument Rd
Ste 1100
York, PA 17403
Phone (717) 851-2441

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

Interoperability endpoints

  • Direct secure messaging: ahernandez475624@wellspan.direct-ci.com

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 6

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": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1497551121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-0958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Monument Rd Ste 1100",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035024",
            "country_code": "US",
            "telephone_number": "717-851-2441",
            "fax_number": "717-260-3322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "AMANDA",
        "credential": "RN, CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-24",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP032501",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R228228",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "THEILLER",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.