Individual provider Active NPI

Ama Nimako-Boateng, CRNP

  • Nurse Practitioner
  • Orwigsburg, PA
National Provider Identifier
1750105771
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP031330 Issued in PA
Practice address
100 Paramount Blvd
Orwigsburg, PA 17961-2202
Phone
(272) 639-1000
NPI assigned
Nov 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP031330 PA Primary

Addresses

Primary practice location

100 Paramount Blvd
Orwigsburg, PA 17961-2202

Mailing address

100 Paramount Blvd
Orwigsburg, PA 17961-2202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20241206003721 PA Practitioner - Nurse Practitioner 9032645551 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gslpg, IncGroup PAC ID 7810226875, 269 clinicians
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

100 Paramount Blvd
Orwigsburg, PA 17961-2202
Phone (484) 526-2440

1736 Hamilton St
Allentown, PA 18104-5656
Phone (484) 526-8142

1736 W Hamilton St
Allentown, PA 18104-5656
Phone (610) 954-3571

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • Geisinger St. Luke'S Hospital Hospital, Orwigsburg, PA, CCN 390332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP031330PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
St. Luke'S Physician Group, Inc CurrentSince Nov 14, 2024 Accepting new patients
St Luke'S Physician Group Inc CurrentSince Nov 14, 2024 Accepting new patients
Gslpg, Inc CurrentSince Nov 14, 2024 Accepting new patients

Locations

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

100 Paramount Blvd
Orwigsburg, PA 17961
Phone (272) 639-1000

Interoperability endpoints

  • Direct secure messaging: animakoboateng277403@direct-sluhn.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 7

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": "1731628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1750105771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PARAMOUNT BLVD",
            "city": "ORWIGSBURG",
            "state": "PA",
            "postal_code": "179612202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PARAMOUNT BLVD",
            "city": "ORWIGSBURG",
            "state": "PA",
            "postal_code": "179612202",
            "telephone_number": "272-639-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMAKO-BOATENG",
        "first_name": "AMA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP031330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orwigsburg, PA

Sources for this page

Verify at the official NPI Registry.