Individual provider Active NPI

Amanda Ciesla

  • Clinical Social Worker
  • Amherst, NY
National Provider Identifier
1609388529
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
094152 Issued in NY
Practice address
6225 Sheridan Dr Ste 222
Amherst, NY 14221-4800
Phone
(716) 249-4063
NPI assigned
Nov 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 097789 NY
Clinical Social Worker 1041C0700X 094152 NY Primary

Addresses

Primary practice location

6225 Sheridan Dr Ste 222
Amherst, NY 14221-4800

Mailing address

6225 Sheridan Dr Ste 222
Amherst, NY 14221-4800
Phone (716) 249-4063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230221001612 NY Practitioner - Clinical Social Worker 7618349671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shurmatz Counseling, LCSW, PCGroup PAC ID 1153651179, 19 clinicians

Practice addresses (Care Compare)

2355 Union Rd
Suite 200
Cheektowaga, NY 14227-2234
Phone (716) 217-6112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
097789NYMDCounselor
094152NYMDSocial Worker

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1609388529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 SHERIDAN DR STE 222",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142214800",
            "telephone_number": "716-249-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6225 SHERIDAN DR STE 222",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142214800",
            "telephone_number": "716-249-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIESLA",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "097789",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.