Amy N Albert, PA-C
Individual provider Active NPI Medical Physician Assistant · Philadelphia, PA
NPI 1679639397 · NPPES record last updated Feb 8, 2008
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Feb 20, 2018.
Key facts
- NPI
- 1679639397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- MA051885 (PA)
- Practice address
- 3819 Chestnut St
Ste. 205
Philadelphia, PA 19104-3171 - Phone
- (215) 662-8777
- Fax
- (215) 243-4601
- NPI assigned
- Dec 28, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA051885 | PA | MD | Medical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA051885 | PA | Yes |
Addresses
Primary practice location
3819 Chestnut St
Ste. 205
Philadelphia, PA 19104-3171
Mailing address
3819 Chestnut St
Ste 205
Philadelphia, PA 19104-3171
Other names
- Amy Clevenstine
NPI Registry JSON
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202428800000",
"number": "1679639397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3819 CHESTNUT ST",
"address_2": "STE 205",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191043171",
"fax_number": "215-243-4601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3819 CHESTNUT ST",
"address_2": "STE. 205",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191043171",
"telephone_number": "215-662-8777",
"fax_number": "215-243-4601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALBERT",
"first_name": "AMY",
"middle_name": "N",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-28",
"last_updated": "2008-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA051885",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "CLEVENSTINE",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Philadelphia, PA
- Albert Einstein Medical Center
- Albert Einstein Medical Center
- Albert Einstein Medical Center
- Albert Einstin Healthcare Network
- Albert Eintein Medical Center
- Johanna Albert
- Lawrence Albert
- Lewis M Albert
- Sonya Romana Albert
- Amelia Hope Alberts
All providers in Philadelphia, PA · Medical Physician Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- OIG LEIE (HHS Office of Inspector General).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.