Amy Ann Kowal

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN2265800 Issued in MA

Practice address

417 Liberty St
Springfield, MA 01104-3736

Phone

(413) 747-0705

Fax

(413) 732-7075

NPI assigned

Mar 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  MA

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1649773268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 LIBERTY ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011043736",
            "telephone_number": "413-747-0705",
            "fax_number": "413-732-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 LIBERTY ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011043736",
            "telephone_number": "413-747-0705",
            "fax_number": "413-732-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWAL",
        "first_name": "AMY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-09",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2265800",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2265800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yudelka Kotjahasan, PSY.D.
• Jenna Kotlyarenko
• Mariame Kounta
• John S Kovalchik Jr., LICSW
• Karina Kovalevich, RN, BSN, MSN, FNP-BC
• Kristen N/a Kowal
• Kelly Rose Kowalczyk, CRNA
• Ryan Kowalsky, MD
• Amanda Marie Kozlik, PHARMD, RPH
• Christina Rae Kozlowski

• Family Nurse Practitioner in Springfield, MA
• Providers in Springfield, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.