Amanda Mindela, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

23868 Issued in MN

Practice address

2121 Campus Dr SE
Rochester, MN 55904-4744

Phone

(507) 322-3019

NPI assigned

Jan 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amanda Shilts Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nexus Family Healing

  • Neurology Physician
  • Rochester, MN
  • NPI 1851905251
  Medicare reassignment NPD

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1760134092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 CAMPUS DR SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559044744",
            "telephone_number": "507-322-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 CAMPUS DR SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559044744",
            "telephone_number": "507-322-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINDELA",
        "first_name": "AMANDA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scc-admin@serccnexus.org",
            "affiliation": "N",
            "endpointDescription": "Admin Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2121 Campus Dr SE",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559044744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "SHILTS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Social Worker in Rochester, MN
• Providers in Rochester, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.