Active NPI
Amanda D Palumbo, PA
- Physician Assistant
- Moore, OK
National Provider Identifier
1710192075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1625
- Practice address
- 700 S Telephone Rd
Moore, OK 73160-2502 - Phone
- (405) 793-9355
- NPI assigned
- May 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1625 | OK | Primary |
Addresses
Primary practice location
700 S Telephone Rd
Moore, OK 73160-2502
Mailing address
22722 State Highway 74
Purcell, OK 73080-6953
Phone (405) 802-3905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4220 N Classen Blvd
Suite F
Oklahoma City, OK 73118-2416
Phone (405) 259-2333
Merit-based Incentive Payment System (MIPS)
- Final score
- 23.04 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 76.78
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 2
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.
-
- Psychiatry Physician
- Oklahoma City, OK
- NPI 1215516950
-
- Emergency Medicine Physician
- Oklahoma City, OK
- NPI 1558386474
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710192075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22722 STATE HIGHWAY 74",
"city": "PURCELL",
"state": "OK",
"postal_code": "730806953",
"telephone_number": "405-802-3905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 S TELEPHONE RD",
"city": "MOORE",
"state": "OK",
"postal_code": "731602502",
"telephone_number": "405-793-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALUMBO",
"first_name": "AMANDA",
"middle_name": "D",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "1625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moore, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.