Mandie Miller, DMS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4918 Issued in AZ

Practice address

17505 N 79TH Ave Ste 309
Glendale, AZ 85308-8730

Phone

(623) 321-2221

Fax

(855) 397-2676

NPI assigned

Oct 25, 2011

Last updated

Nov 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amanda Anderson Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: frontdesk@pinnaclepsychiatry.com

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.

• Amanda Anderson, MMS, PA-C, PLLC

  dba Pinnacle Psychiatry

  • Psychiatry Physician
  • Glendale, AZ
  • NPI 1073055414
  Authorized official Same address or phone

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1609152479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17505 N 79TH AVE STE 309",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088730",
            "telephone_number": "623-321-2221",
            "fax_number": "855-397-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17505 N 79TH AVE STE 309",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088730",
            "telephone_number": "623-321-2221",
            "fax_number": "855-397-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MANDIE",
        "credential": "DMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4918",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4918",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "FrontDesk@PinnaclePsychiatry.com",
            "affiliation": "N",
            "address_1": "17505 N 79th Ave Ste 407",
            "city": "Glendale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853088732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "frontdesk@pinnaclepsych.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17505 N 79th Ave Ste 309",
            "city": "Glendale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853088730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ANDERSON",
            "credential": "MMS, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine E Miller, OTR/L
• Lauren Noel Miller, NP-C
• Lon Miller, MD
• Lori Miller
• Lori Lee Miller, D.C.
• Micaela Miller
• Nicole Gem Niere Miller, M.S. CCC-SLP
• Patrick R Miller, M.D.
• Shayna Miller, NP
• Sierra Lynn Miller

• Physician Assistant in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.