Individual provider Active NPI

Amanda Vitek, APRN.CNP

  • Family Nurse Practitioner
  • Middleburg Heights, OH
National Provider Identifier
1649737487
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.024354 Issued in OH
Practice address
18697 Bagley Rd
Middleburg Heights, OH 44130-3417
Phone
(440) 816-6051
NPI assigned
Feb 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.024354 OH Primary

Addresses

Primary practice location

18697 Bagley Rd
Middleburg Heights, OH 44130-3417

Mailing address

PO Box 638269
Cincinnati, OH 45263-3417
Phone (440) 816-6051

Other practice location 1

2045 Marlowe Ave
Lakewood, OH 44107-5946
Phone (440) 212-0014

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ajohnson@direct.swgeneral.com Southwest General Medical Group, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190625001065 OH Practitioner - Nurse Practitioner 1456685403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

18697 Bagley Rd
Cleveland, OH 44130-3417
Phone (440) 816-6051

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
63.56
Promoting interoperability
100
Improvement activities
40
Cost
73.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest General Medical Group, Inc. CurrentSince May 6, 2019 Accepting new patients
Southwest General Medical Group Inc Current Accepting new patients
Southwest General Medical Group Inc CurrentSince May 6, 2019 Accepting new patients

Locations

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

7255 Old Oak Blvd
Ste C202
Middleburg Heights, OH 44130
Phone (440) 816-5390

Interoperability endpoints

  • Direct secure messaging: ajohnson@direct.swgeneral.com
  • Direct secure messaging: avitek547526@ehrdirect.uhhospitals.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1649737487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638269",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452633417",
            "telephone_number": "440-816-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18697 BAGLEY RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303417",
            "telephone_number": "440-816-6051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2045 Marlowe Ave",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "OH",
            "postal_code": "441075946",
            "country_code": "US",
            "telephone_number": "440-212-0014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VITEK",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "APRN.CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.024354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajohnson@direct.swgeneral.com",
            "affiliation": "Y",
            "affiliationName": "Southwest General Medical Group, Inc",
            "address_1": "18697 Bagley Rd",
            "city": "Middleburg Heights",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441303417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middleburg Heights, OH

Sources for this page

Verify at the official NPI Registry.