Individual provider Active NPI

Amanda Martin Riley, PA-C

  • Medical Physician Assistant
  • S Weymouth, MA
National Provider Identifier
1629300868
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA3935 Issued in MA
Practice address
55 Fogg Rd
S Weymouth, MA 02190-2455
Phone
(781) 624-8000
NPI assigned
Feb 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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 PA3935 MA Primary

Addresses

Primary practice location

55 Fogg Rd
S Weymouth, MA 02190-2455

Mailing address

55 Fogg Rd
South Weymouth, MA 02190-2455
Phone (781) 624-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20100814000044 MA Practitioner - Physician Assistant 4385778216 Reassigns benefits to 6 organizations

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
Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

2014 Washington St
Newton, MA 02462-1607
Phone (617) 243-6000

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 792-4136

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021647NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Hospitalists of New England PC CurrentSince Sep 1, 2016 Accepting new patients
Newton Wellesley Hospital Current Accepting new patients
Ipc Hospitalists of New England, P.C. Medical CurrentSince Sep 1, 2016 Accepting new patients
Hebrew Rehabilitation Center CurrentSince Jul 22, 2019 Accepting new patients
Medpulse LLC Past Accepting new patients

Locations

200 Groton Rd
Ayer, MA 01432
Phone (978) 784-9000

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

795 Middle St
Fall River, MA 02721
Phone (508) 235-5046

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

67 Union St
Natick, MA 01760
Phone (508) 383-1104

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

800 Washington St
Norwood, MA 02062
Phone (781) 278-6264

111 Huntoon Memorial Hwy
Rochdale, MA 01542
Phone (508) 892-4858

1200 Centre St
Roslindale, MA 02131
Phone (617) 363-8000

37 State Highway 6A
Sandwich, MA 02563
Phone (508) 888-8222

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

Interoperability endpoints

  • Direct secure messaging: martin.amanda.nwh@direct.partners.masshiway.net

Organizations & group practices 10

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 1

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": "1265932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1629300868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021902455",
            "telephone_number": "781-624-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "city": "S WEYMOUTH",
            "state": "MA",
            "postal_code": "021902455",
            "telephone_number": "781-624-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "AMANDA",
        "middle_name": "MARTIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-12",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA3935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in S Weymouth, MA

Sources for this page

Verify at the official NPI Registry.