Amy Jeanne Brueckner Amedure, DO
Individual provider Active NPI Family Medicine Physician · Ellicottville, NY
NPI 1598744690 · NPPES record last updated Jan 22, 2020
Key facts
- NPI
- 1598744690
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 233710 (NY)
- Practice address
- 14 Bristol LN
Ellicottville, NY 14731 - Phone
- (716) 699-9032
- Fax
- (716) 699-9035
- NPI assigned
- Jan 17, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (6 enrollments) in NY, IN, OH, PA, MI, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050820000029 | NY | Practitioner - Osteopathic Manipulative Medicine |
0446280341 | Reassigns benefits to 3 organizations |
| I20220914002252 | IN | Practitioner - Family Practice | 0446280341 | Reassigns benefits to 1 organization |
| I20221103000152 | OH | Practitioner - Family Practice | 0446280341 | Reassigns benefits to 2 organizations |
| I20240327001539 | PA | Practitioner - Family Practice | 0446280341 | Reassigns benefits to 1 organization |
| I20240405002419 | MI | Practitioner - Family Practice | 0446280341 | Reassigns benefits to 2 organizations |
| I20240802001964 | IL | Practitioner - Family Practice | 0446280341 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 233710 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Urgent Care of Michigan, P.C. | Current | Accepting new patients | |
| Pic Indiana PC | Current |
Accepting new patients | |
| University Hospitals Urgent Care, LLC | Current |
Accepting new patients | |
| St. Peter'S Health Partners Medical Associates, P.C. | Family Medicine | Current |
Accepting new patients |
| Physicians Immediate Care North Chicago LLC | Current |
Accepting new patients | |
| University Hospitals Urgent Care, LLC | Current |
Accepting new patients | |
| Wellnow Urgent Care, PC | Current |
Accepting new patients | |
| Rosendale Medical Center Urgent Care | Past |
Accepting new patients | |
| Primary Eyecare Optometry PC | Past |
Accepting new patients | |
| Hudson Valley Family Physicians | Family Medicine | Past | Accepting new patients |
| Ajb Family Medicine PC | Past |
Accepting new patients |
Locations (25 of 28)
4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000
13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384
1840 N Richmond Rd
McHenry, IL 60051
Phone (779) 704-3075
3800 S Scatterfield Rd
Anderson, IN 46013
Phone (765) 203-2051
123 S Franklin Rd
Bloomington, IN 47404
Phone (812) 339-2305
3019 N National Rd
Columbus, IN 47201
Phone (812) 314-7617
1124 S 13th St
Decatur, IN 46733
Phone (260) 706-5039
900 Johnson St
#A
Elkhart, IN 46514
924 W Pike St
Goshen, IN 46526
Phone (574) 312-7056
4903 S Emerson Ave
Indianapolis, IN 46203
Phone (317) 352-5582
1010 S Reed Rd
Kokomo, IN 46901
Phone (765) 252-2176
102 Sagamore Pkwy S
Lafayette, IN 47905
Phone (765) 237-3224
630 Birk Rd
Martinsville, IN 46151
Phone (765) 341-2091
505 W Cleveland Rd
Mishawaka, IN 46545
Phone (574) 235-3135
1313 W McGalliard Rd
Muncie, IN 47303
Phone (765) 216-3115
1245 E Ireland Rd
#B
South Bend, IN 46614
Phone (574) 312-7022
2680 Escalade Way
Warsaw, IN 46582
Phone (574) 306-4128
1131 M 32 W
Alpena, MI 49707
Phone (989) 250-1925
25 Columbia Ave E
Battle Creek, MI 49015
Phone (269) 425-3017
1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835
3550 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-2530
6870 E Genesee St
Fayetteville, NY 13066
Phone (315) 679-4367
446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496
7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064
854 Route 212
Saugerties, NY 12477
Phone (845) 246-2074
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 233710 | NY | Yes |
Addresses
Primary practice location
14 Bristol LN
Ellicottville, NY 14731
Mailing address
57 Woodland LN
Palenville, NY 12463-2525
Phone (518) 542-4643
Other practice location 1
854 Route 212
Saugerties, NY 12477-4619
Phone (845) 246-2804
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02701077 | Medicaid | NY |
Other providers in Ellicottville, NY
- Stephanie Adamchak
- Hamud Alasri
- Anew Beginning Massage and Spa
- Joanne Bennett Timkey
- Lindsey Marie Bradley
- Chantele Comstock
- Tracy J Draper
All providers in Ellicottville, NY · Family Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.