Individual provider Active NPI

Amanda Ford-Trotter, PA-C

  • Medical Physician Assistant
  • Cooper City, FL
National Provider Identifier
1619378510
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PAT9108161 Issued in FL
Practice address
11011 Sheridan Street
Suite 302
Cooper City, FL 33026
Phone
(954) 437-1500
NPI assigned
Sep 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PAT9108161 FL Primary

Addresses

Primary practice location

11011 Sheridan Street
Suite 302
Cooper City, FL 33026

Mailing address

11011 Sheridan Street
Suite 302
Cooper City, FL 33026
Phone (954) 437-1500

Other practice location 1

601 N Flamingo Rd
Suite 105
Pembroke Pines, FL 33028-1015
Phone (954) 967-6550 ext. 112

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL na
Other URL na

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150121000653 FL Practitioner - Physician Assistant 3173847290 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAT9108161FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthstone Medical Group, LLC CurrentSince Jan 18, 2017 Accepting new patients

Locations

2905 N Commerce Pkwy
Miramar, FL 33025
Phone (833) 582-1017

700 N Hiatus Rd
Ste 105
Pembroke Pines, FL 33026
Phone (954) 433-4744

601 N Flamingo Rd
Ste 105
Pembroke Pnes, FL 33028
Phone (954) 430-3866

Interoperability endpoints

  • Direct secure messaging: amanda.fordtrotter.p34@direct.medcor.nextgenshare.com

Organizations & group practices 4

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": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1619378510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 SHERIDAN STREET",
            "address_2": "SUITE 302",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "33026",
            "telephone_number": "954-437-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 SHERIDAN STREET",
            "address_2": "SUITE 302",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "33026",
            "telephone_number": "954-437-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 N Flamingo Rd",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281015",
            "country_code": "US",
            "telephone_number": "954-967-6550 x112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORD-TROTTER",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-10",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PAT9108161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "na",
            "affiliation": "N",
            "address_1": "11011 Sheridan Street",
            "address_2": "Suite 302",
            "city": "Cooper City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "na",
            "affiliation": "N",
            "address_1": "11011 Sheridan Street",
            "address_2": "Suite 302",
            "city": "Cooper City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cooper City, FL

Sources for this page

Verify at the official NPI Registry.