Individual provider Active NPI

Amanda Michelle Deering, PA-C

  • Physician Assistant
  • Conroe, TX
National Provider Identifier
1578296406
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16749 Issued in TX
Practice address
1020 Riverwood CT Ste 305
Conroe, TX 77304-2974
Phone
(832) 447-7494
Fax
(832) 510-0563
NPI assigned
Jul 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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 PA16749 TX Primary

Addresses

Primary practice location

1020 Riverwood CT Ste 305
Conroe, TX 77304-2974

Mailing address

1020 Riverwood CT Ste 305
Conroe, TX 77304-2974
Phone (832) 447-7494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240507003853 TX Practitioner - Physician Assistant 7315388451 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Minimally Invasive Neurosurgery PLLCGroup PAC ID 8921472325, 5 clinicians

Practice addresses (Care Compare)

1020 Riverwood CT
Suite 305
Conroe, TX 77304-2974
Phone (612) 961-7513

1710 W Lake Houston Pkwy
Suite 260
Kingwood, TX 77339-2674
Phone (832) 447-7494

Hospital & facility affiliations

  • Memorial Hermann Surgical Hospital Kingwood Hospital, Kingwood, TX, CCN 670005
  • HCA Houston Healthcare Conroe Hospital, Conroe, TX, CCN 450222

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Olga Swanson MD PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amanda.deering.1@11939.direct.athenahealth.com

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.

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": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1578296406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 RIVERWOOD CT STE 305",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042974",
            "telephone_number": "832-447-7494",
            "fax_number": "832-510-0563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 RIVERWOOD CT STE 305",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042974",
            "telephone_number": "832-447-7494",
            "fax_number": "832-510-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEERING",
        "first_name": "AMANDA",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.