Individual provider Active NPI

Amanda Lee Kottyan, CNP

  • Women's Health Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1760890230
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
COA 16267 NP Issued in OH
Practice address
5050 Section Ave FL 2
Cincinnati, OH 45212-2055
Phone
(513) 946-7610
Fax
(513) 946-7603
NPI assigned
Jul 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X COA 16267 NP OH Primary

Addresses

Primary practice location

5050 Section Ave FL 2
Cincinnati, OH 45212-2055

Mailing address

5050 Section Ave FL 2
Cincinnati, OH 45212-2055
Phone (513) 946-7610

Other names 1

  • Amanda Dobson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20140915001521 OH Practitioner - Nurse Practitioner 9537388087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

184 E McMillan St
Cincinnati, OH 45219-2607
Phone (513) 946-7800

250 William Howard Taft Rd
Cincinnati, OH 45219-2607

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA 16267 NPOHMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Hamilton CurrentSince Dec 13, 2024 Accepting new patients
Hamilton County PastSince Nov 1, 2023 Accepting new patients

Locations

250 Wm Howard Taft Rd
Cincinnati, OH 45219

5050 Section Ave
Ste 200
Cincinnati, OH 45212

Interoperability endpoints

  • Direct secure messaging: akottyan2377986@direct.bsmhealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1760890230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SECTION AVE FL 2",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122055",
            "telephone_number": "513-946-7610",
            "fax_number": "513-946-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 SECTION AVE FL 2",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122055",
            "telephone_number": "513-946-7610",
            "fax_number": "513-946-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTTYAN",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-29",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "COA 16267 NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "DOBSON",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.