Individual provider Active NPI

Amy Louise Defazio, MSN FNP-C

  • Family Nurse Practitioner
  • Uniontown, PA
National Provider Identifier
1578347613
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
117346 Issued in WV
Practice address
500 W Berkeley St
Uniontown, PA 15401-5514
Phone
(724) 430-5000
NPI assigned
Aug 21, 2023
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 117346 WV Primary

Addresses

Primary practice location

500 W Berkeley St
Uniontown, PA 15401-5514

Mailing address

1121 N Gallatin Avenue Ext
Uniontown, PA 15401-2111
Phone (724) 320-8486

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
I20240122000404 PA Practitioner - Nurse Practitioner 3678925096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Pennsylvania State University College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fayette Physician Network IncGroup PAC ID 3375865819, 309 clinicians

Practice addresses (Care Compare)

100 Woodlawn Ave
Uniontown, PA 15401-3105
Phone (724) 430-5600

201 Mary Higginson LN
Uniontown, PA 15401-2658
Phone (724) 430-5940

205 Mary Higginson LN
Uniontown, PA 15401-2658
Phone (724) 276-0712

500 W Berkeley St
Uniontown, PA 15401-5514
Phone (724) 430-6899

500 W Berkely St Annex
Uniontown Specialty Care
Uniontown, PA 15401-5514
Phone (724) 430-5600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
117346WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fayette Physician Network Inc CurrentSince Jan 15, 2024 Accepting new patients
Fayette Physician Network Inc Family CurrentSince Jan 15, 2024 Accepting new patients
Fayette Physician Network Inc Past Accepting new patients

Locations

100 Woodlawn Ave
Uniontown, PA 15401
Phone (724) 438-8765

100 Woodlawn Ave
Ste 2
Uniontown, PA 15401
Phone (724) 430-5600

201 Mary Higginson Ln
Uniontown, PA 15401
Phone (724) 430-5940

500 W Berkeley St
Uniontown, PA 15401
Phone (724) 430-5000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1578347613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 N GALLATIN AVENUE EXT",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154012111",
            "telephone_number": "724-320-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BERKELEY ST",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154015514",
            "telephone_number": "724-430-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFAZIO",
        "first_name": "AMY",
        "middle_name": "LOUISE",
        "credential": "MSN FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "117346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Uniontown, PA

Sources for this page

Verify at the official NPI Registry.