Individual provider Active NPI

Amanda Sahar Santos, PA-C

  • Medical Physician Assistant
  • Greenwood Village, CO
National Provider Identifier
1538755590
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0006985 Issued in CO
Practice address
9250 E Costilla Ave Ste 540
Greenwood Village, CO 80112-3648
Phone
(720) 644-9355
NPI assigned
Dec 14, 2020
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA.0006985 CO Primary

Addresses

Primary practice location

9250 E Costilla Ave Ste 540
Greenwood Village, CO 80112-3648

Mailing address

5441 Lynx St
Frederick, CO 80504-3408
Phone (724) 841-9560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20211014000751 CO Practitioner - Physician Assistant 4183039282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Consultants PLLCGroup PAC ID 0547589517, 78 clinicians

Practice addresses (Care Compare)

12230 Lioness Way
Parker, CO 80134-5603
Phone (720) 644-9355

1440 Coffman St
Longmont, CO 80501-2726
Phone (303) 776-2814

Merit-based Incentive Payment System (MIPS)

Final score
76.42 of 100Reported as apm
Quality
55.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0006985COMDMedical Physician Assistant

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1538755590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5441 LYNX ST",
            "city": "FREDERICK",
            "state": "CO",
            "postal_code": "805043408",
            "telephone_number": "724-841-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 E COSTILLA AVE STE 540",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801123648",
            "telephone_number": "720-644-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "AMANDA",
        "middle_name": "SAHAR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0006985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood Village, CO

Sources for this page

Verify at the official NPI Registry.