Individual provider Active NPI

Amanda P Stiteler, M.D.

  • Urology Physician
  • Williamsburg, VA
National Provider Identifier
1679918700
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
0101264870 Issued in VA
Practice address
120 Kings Way Ste 3200
Williamsburg, VA 23185-2511
Phone
(757) 253-0051
Fax
(757) 229-9526
NPI assigned
May 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Urology Physician 208800000X 0101264870 VA Primary

Addresses

Primary practice location

120 Kings Way Ste 3200
Williamsburg, VA 23185-2511

Mailing address

7703 Floyd Curl Dr
San Antonio, TX 78229-3901

Other practice location 1

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 567-5711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180918003670 VA Practitioner - Urology 7416247580 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services, Inc. Urology CurrentSince Sep 10, 2018 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services Inc CurrentSince Sep 10, 2018 Accepting new patients

Locations

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

500 J Clyde Morris Blvd
Ste 500
Newport News, VA 23601
Phone (757) 873-1317

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

120 Kings Way
Ste 3300
Williamsburg, VA 23185
Phone (757) 221-0750

120 Kings Way
Ste 3200
Williamsburg, VA 23185
Phone (757) 253-0051

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1679918700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 KINGS WAY STE 3200",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852511",
            "telephone_number": "757-253-0051",
            "fax_number": "757-229-9526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4502 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782294402",
            "country_code": "US",
            "telephone_number": "210-567-5711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STITELER",
        "first_name": "AMANDA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-02",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101264870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.