Individual provider Active NPI

Amanda Fabian, PA-C

  • Medical Physician Assistant
  • Gering, NE
National Provider Identifier
1679026231
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2837 Issued in NE
Practice address
2855 10TH St Ste B
Gering, NE 69341-2202
Phone
(308) 633-1325
NPI assigned
Aug 1, 2016
Last updated
Jun 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA962 WY
Medical Physician Assistant 363AM0700X 2837 NE Primary

Addresses

Primary practice location

2855 10TH St Ste B
Gering, NE 69341-2202

Mailing address

2855 10TH St Ste B
Gering, NE 69341-2202
Phone (308) 633-1325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, NE, SD3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220223000508 WY Practitioner - Physician Assistant 1456634468 Reassigns benefits to 2 organizations
I20230828003882 NE Practitioner - Physician Assistant 1456634468 Reassigns benefits to 1 organization
I20260219003066 SD Practitioner - Physician Assistant 1456634468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sweet Dreams Sleep Services PCGroup PAC ID 7618201955, 5 clinicians

Practice addresses (Care Compare)

1730 Haines Ave
Rapid City, SD 57701-0615
Phone (308) 225-0687

2855 10TH St
Suite B
Gering, NE 69341-2202
Phone (308) 633-1325

4112 Laramie St
Cheyenne, WY 82001-1969
Phone (308) 633-1325

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2837NEMDOccupational Therapist
PA962WYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medi Horizons Inc Past Accepting new patients

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 2

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": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1679026231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 10TH ST STE B",
            "city": "GERING",
            "state": "NE",
            "postal_code": "693412202",
            "telephone_number": "308-633-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 10TH ST STE B",
            "city": "GERING",
            "state": "NE",
            "postal_code": "693412202",
            "telephone_number": "308-633-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABIAN",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-01",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "PA962",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "2837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gering, NE

Sources for this page

Verify at the official NPI Registry.