Individual provider Active NPI

Amanda J Lynn, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1578956371
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2491 Issued in NE
Practice address
Emile @ 42ND
Omaha, NE 68198-0001
Phone
(025) 594-4424
NPI assigned
Mar 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 666 NE
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X 2491 NE
Physician Assistant 363A00000X 2491 NE Primary

Addresses

Primary practice location

Emile @ 42ND
Omaha, NE 68198-0001

Mailing address

825 S. 169TH St.
3Rd Floor - South
Omaha, NE 68118
Phone (402) 354-4822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200810000097 NE Practitioner - Physician Assistant 9335564251 Reassigns benefits to 2 organizations
I20220427001129 IA Practitioner - Physician Assistant 9335564251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

1 Edmundson PL
Council Bluffs, IA 51503-4658
Phone (712) 396-4000

10060 Regency Cir
Omaha, NE 68114-3732
Phone (402) 354-1570

11946 Standing Stone Dr
Gretna, NE 68028-8094
Phone (402) 815-4500

201 Ridge St
Council Bluffs, IA 51503-4643

717 N 190TH PLZ
Suite 1100
Elkhorn, NE 68022-3917
Phone (402) 815-1700

808 E Pierce St
Methodist Physicians Clinic
Council Bluffs, IA 51503-4652
Phone (712) 396-4360

Hospital & facility affiliations

  • Angels Care Home Health of Iowa Home health agency, Council Bluffs, IA, CCN 167292
  • Methodist Jennie Edmundson Hospital, Council Bluffs, IA, CCN 160047
  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
666NEMDPhysical Therapy Assistant
2491NEMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Current Accepting new patients
Physicians Clinic Inc Multi-Specialty CurrentSince Jun 1, 2022 Accepting new patients
Nebraska Pediatric Practice, Inc Multi-Specialty PastSince Jan 3, 2021 Accepting new patients
Uno Athletic Training Services Athletic Trainer Past Accepting new patients

Locations

1 Edmundson Pl
Ste 310
Council Bluffs, IA 51503
Phone (712) 328-1801

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

Interoperability endpoints

  • Direct secure messaging: amanda.lynn@direct.nmhs.org

Organizations & group practices 5

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 3

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": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1578956371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 S. 169TH ST.",
            "address_2": "3RD FLOOR - SOUTH",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68118",
            "telephone_number": "402-354-4822",
            "fax_number": "402-354-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EMILE @ 42ND",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681980001",
            "telephone_number": "025-594-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "AMANDA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-18",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NE",
            "license": "666",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "2491",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.