NPIMap

Individual provider Active NPI

Amanda Rose Sweetland, PA

  • Medical Physician Assistant
  • Boise, ID
National Provider Identifier
1619112216
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA-1094 Issued in ID
Practice address
12273 W McMillan Rd
Boise, ID 83713
Phone
(208) 367-6330
Fax
(208) 367-4765
NPI assigned
Dec 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Medical Physician Assistant 363AM0700X PA-1094 ID Primary

Addresses

Primary practice location

12273 W McMillan Rd
Boise, ID 83713

Mailing address

3340 E Goldstone Way
Meridian, ID 83642-1026
Phone (208) 367-6330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20140521002280 ID Practitioner - Physician Assistant 4789807660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3025 W Cherry LN
Meridian, ID 83642-8531

6022 W Emerald St
Boise, ID 83704-8855
Phone (208) 367-4603

6094 W Emerald St
Boise, ID 83704-8855
Phone (208) 302-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-1094IDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Apr 7, 2014 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Apr 7, 2014 Accepting new patients

Locations

1072 N Liberty St
Ste 203
Boise, ID 83704
Phone (208) 302-5800

12273 W McMillan Rd
Boise, ID 83713
Phone (208) 302-5500

6140 W Curtisian Ave
Ste 300
Boise, ID 83704
Phone (208) 367-6575

3217 W Bavaria St
Eagle, ID 83616
Phone (208) 286-6676

323 E Riverside Dr
Ste 224
Eagle, ID 83616
Phone (208) 302-6000

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

Interoperability endpoints

  • Direct secure messaging: asweetland85239@direct.trinity-health.org

Organizations & group practices 3

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": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1619112216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-367-6330",
            "fax_number": "208-367-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12273 W MCMILLAN RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83713",
            "telephone_number": "208-367-6330",
            "fax_number": "208-367-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEETLAND",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-10",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-1094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.