Individual provider Active NPI

Amanda Rose Neal, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1508147687
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4931 Issued in AZ
Practice address
525 N 18TH St Ste 302
Phoenix, AZ 85006-3734
Phone
(602) 254-0200
Fax
(602) 254-0237
NPI assigned
Sep 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4931 AZ Primary

Addresses

Primary practice location

525 N 18TH St Ste 302
Phoenix, AZ 85006-3734

Mailing address

525 N 18TH St Ste 302
Phoenix, AZ 85006-3734
Phone (602) 254-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4931AZMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Pediatrics PastSince Feb 8, 2023 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Arizona Family Clinics Corp PastSince Jan 29, 2023 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426723200000",
    "number": "1508147687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N 18TH ST STE 302",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850063734",
            "telephone_number": "602-254-0200",
            "fax_number": "602-254-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N 18TH ST STE 302",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850063734",
            "telephone_number": "602-254-0200",
            "fax_number": "602-254-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-02",
        "last_updated": "2015-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.