Individual provider Active NPI

Amanda Mae Oliden, PA-C

  • Surgical Physician Assistant
  • Naperville, IL
National Provider Identifier
1689269078
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085008440 Issued in IL
Practice address
801 S Washington St
Naperville, IL 60540-7499
Phone
(630) 527-3000
NPI assigned
Mar 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085008440 IL Primary

Addresses

Primary practice location

801 S Washington St
Naperville, IL 60540-7499

Mailing address

801 S Washington St
Naperville, IL 60540-7499
Phone (630) 527-3000

Other practice location 1

155 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (331) 221-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20220426001383 IL Practitioner - Physician Assistant 1658768452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

155 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (331) 221-0096

177 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (630) 646-6020

2650 Ridge Ave
Evanston, IL 60201-1700

801 S Washington St
Naperville, IL 60540-7430
Phone (630) 527-5197

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085008440ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Health Ventures CurrentSince Jan 20, 2022 Accepting new patients
Edward Health Ventures CurrentSince Jan 20, 2022 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 11, 2023 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

155 E Brush Hill Rd
Elmhurst, IL 60126
Phone (331) 221-3521

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

801 S Washington St
Naperville, IL 60540
Phone (312) 355-0450

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

Interoperability endpoints

  • Direct secure messaging: awenger239893@direct.edward.org

Organizations & group practices 4

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.

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": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1689269078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S WASHINGTON ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407499",
            "telephone_number": "630-527-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S WASHINGTON ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407499",
            "telephone_number": "630-527-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 E Brush Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "IL",
            "postal_code": "601265658",
            "country_code": "US",
            "telephone_number": "331-221-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIDEN",
        "first_name": "AMANDA",
        "middle_name": "MAE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-08",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085008440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.