Amanda Michel Marinova, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA057653 Issued in PA

Practice address

919 N Front St Apt G
Philadelphia, PA 19123-1715

Phone

(856) 889-8816

NPI assigned

Jun 16, 2015

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

Other names 1

• Amanda Michel Viereck Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1669853628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 N FRONT ST APT G",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231715",
            "telephone_number": "856-889-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 N FRONT ST APT G",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231715",
            "telephone_number": "856-889-8816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINOVA",
        "first_name": "AMANDA",
        "middle_name": "MICHEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00369500",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "VIERECK",
            "middle_name": "MICHEL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ralph J. Marino, M.D.
• Reina Anne Marino, M.D.
• Susan Marino, L.AC M.AC
• Jenna Maxine Marinock, MD
• Andrew James Marinos, BS MOT
• Adrian Mayo Marinovich, M.D.
• Beth Ann Marion, CRNP
• Louis R Marion, DMD MS
• Sarah Marion, MD
• William G Marion, CRNA

• Medical Physician Assistant in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.