Amanda Dora Burnette, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110007351 Issued in VA

Practice address

11930 Democracy Dr
Reston, VA 20190-5624

Phone

(202) 627-1901

NPI assigned

Sep 25, 2016

Last updated

Oct 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amanda Smith Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, VA2 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 2

Specialty

Physician Assistant

Education

Midwestern University College of Dental Medicine, Glendale, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

One Medstar Primary Care LLCGroup PAC ID 0749607307, 140 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vaexchange@patientfirstclinics.com

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.

• One Medstar Primary Care LLC

  • Family Medicine Physician
  • Washington, DC
  • NPI 1417571530
  Medicare reassignment Care Compare group
• Patient First Richmond Medical Group PLLC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1689603748

  DC

  Medicare reassignment NPD
• Patient First Richmond Medical Group PLLC

  • Urgent Care Clinic/Center
  • Fairfax, VA
  • NPI 1588018881
  NPD

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

{
    "created_epoch": "1474761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1740739242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11930 DEMOCRACY DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905624",
            "telephone_number": "202-627-1901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2199 Old Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Ridge",
            "state": "VA",
            "postal_code": "221922911",
            "country_code": "US",
            "telephone_number": "703-357-9707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNETTE",
        "first_name": "AMANDA",
        "middle_name": "DORA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-25",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110007351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "2199 Old Bridge Rd",
            "city": "Lake Ridge",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221922911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "SMITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tra P Bui, MD
• Tamra Marie Bullard, PT
• Paul Burke, M.D.
• Colleen Burkhart, PA-C
• Gregory Burkhart, M.D.
• Charles Ernest Burt, PH.D.
• Arlene Butler, M.S.W.
• Cara Elizabeth Butler
• Scott Michael Butler, MD
• Katherine Butters

• Physician Assistant in Reston, VA
• Providers in Reston, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.

Verify at the official NPI Registry.