Active NPI
Amanda Jo Petri, M.A.
- Audiologist
- Woodbury, MN
National Provider Identifier
1760547269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 8026
- Practice address
- 217 Radio Dr
Woodbury, MN 55125-5805 - Phone
- (651) 702-0750
- Fax
- (651) 645-6166
- NPI assigned
- Dec 26, 2006
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 8026 | MN | Primary |
Addresses
Primary practice location
217 Radio Dr
Woodbury, MN 55125-5805
Mailing address
215 Radio Dr Ste 202
Woodbury, MN 55125-5822
Phone (651) 702-0750
Other practice location 1
3590 Arcade St
Vadnais Heights, MN 55127-7135
Phone (651) 702-0750
Other practice location 2
11020 161st Street West
Lakeville, MN 55044
Phone (651) 702-0750
Other practice location 3
3460 Promenade Ave
Eagan, MN 55123-4404
Phone (651) 702-0750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
217 Radio Dr
Woodbury, MN 55125-5805
Phone (651) 702-0750
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8026 | MN | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Ancillary Services, Inc | Past | Accepting new patients |
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.
-
- Otolaryngology Physician
- Woodbury, MN
- NPI 1821195959
-
- Hearing Aid Equipment
- Woodbury, MN
- NPI 1588754584
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763596800000",
"number": "1760547269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 RADIO DR STE 202",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551255822",
"telephone_number": "651-702-0750",
"fax_number": "651-645-6166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "217 RADIO DR",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551255805",
"telephone_number": "651-702-0750",
"fax_number": "651-645-6166"
}
],
"practiceLocations": [
{
"address_1": "3590 Arcade St",
"address_purpose": "LOCATION",
"city": "Vadnais Heights",
"state": "MN",
"postal_code": "551277135",
"country_code": "US",
"telephone_number": "651-702-0750",
"fax_number": "651-645-6166",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11020 161st Street West",
"address_purpose": "LOCATION",
"city": "Lakeville",
"state": "MN",
"postal_code": "55044",
"country_code": "US",
"telephone_number": "651-702-0750",
"fax_number": "651-645-6166",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3460 Promenade Ave",
"address_purpose": "LOCATION",
"city": "Eagan",
"state": "MN",
"postal_code": "551234404",
"country_code": "US",
"telephone_number": "651-702-0750",
"fax_number": "651-645-6166",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETRI",
"first_name": "AMANDA",
"middle_name": "JO",
"name_prefix": "Ms.",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-26",
"last_updated": "2025-11-20",
"certification_date": "2025-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MN",
"license": "8026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Woodbury, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.