NPIMap

Individual provider Active NPI

Amanda K Thate, PA-C

  • Physician Assistant
  • Springfield, IL
National Provider Identifier
1609597871
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1301 S Koke Mill Rd
Springfield, IL 62711-9252
Phone
(217) 547-9100
NPI assigned
Sep 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1301 S Koke Mill Rd
Springfield, IL 62711-9252

Mailing address

PO Box 9469
Springfield, IL 62791-9469
Phone (217) 547-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240906002478 OH Practitioner - Physician Assistant 0749659282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

13207 Ravenna Rd
Chardon, OH 44024-7032
Phone (216) 383-0100

13207 Ravenna Rd H
Chardon, OH 44024-7032
Phone (216) 383-0100

13221 Ravenna Rd
Chardon, OH 44024-9016

158 W Main Rd
Conneaut, OH 44030-2039

8819 Commons Blvd
Twinsburg, OH 44087-4102

Hospital & facility affiliations

  • University Hospitals Portage Medical Center Hospital, Ravenna, OH, CCN 360078
  • Uh Regional Hospitals Hospital, Chardon, OH, CCN 360075
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137
  • Lake Health Hospital, Concord, OH, CCN 360098
  • Uhhs Memorial Hospital of Geneva Hospital, Geneva, OH, CCN 361307

Merit-based Incentive Payment System (MIPS)

Final score
63.56 of 100Reported as group
Quality
57.12
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince Jul 15, 2024 Accepting new patients
University Primary Care Practices Inc CurrentSince Jul 15, 2024 Accepting new patients
University Primary Care Practices Past Accepting new patients
Orthopaedic Center of Illinois PastSince Sep 11, 2022 Accepting new patients
Multicare Health System Physician Assistant Past Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients

Locations

13221 Ravenna Rd
Ste 12
Chardon, OH 44024
Phone (216) 286-5433

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

8819 Commons Blvd
Ste 200
Twinsburg, OH 44087
Phone (330) 405-9147

Interoperability endpoints

  • Direct secure messaging: athate585002@ehrdirect.uhhospitals.org

Organizations & group practices 7

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 8

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": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1609597871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9469",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627919469",
            "telephone_number": "217-547-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S KOKE MILL RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627119252",
            "telephone_number": "217-547-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THATE",
        "first_name": "AMANDA",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.