NPIMap

Individual provider Active NPI

Amylyn Mortimer

  • Physician Assistant
  • Fountain Hill, PA
National Provider Identifier
1760993638
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA059455 Issued in PA
Practice address
701 Ostrum St Ste 503
Fountain Hill, PA 18015-1153
Phone
(484) 526-3950
Fax
(484) 526-8270
NPI assigned
Oct 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA059455 PA Primary

Addresses

Primary practice location

701 Ostrum St Ste 503
Fountain Hill, PA 18015-1153

Mailing address

701 Ostrum St Ste 503
Fountain Hill, PA 18015-1153
Phone (484) 526-3950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180329002375 PA Practitioner - Physician Assistant 1557623626 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

701 Ostrum St
Fountain Hill, PA 18015-1152

701 Ostrum St
Fountain Hill, PA 18015-1184

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA059455PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group, Inc. CurrentSince Mar 4, 2024 Accepting new patients
Geisinger Clinic CurrentSince Apr 6, 2020 Accepting new patients
St Luke's Physician Group Inc CurrentSince Mar 4, 2024 Accepting new patients
Geisinger Clinic CurrentSince Apr 6, 2020 Accepting new patients
Einstein Practice Plan Inc CurrentSince Feb 11, 2018 Accepting new patients
Einstein Practice Plan Inc CurrentSince Feb 11, 2018 Accepting new patients
St. Luke's Physician Group, Inc Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

240 Cetronia Rd
Ste 225S
Allentown, PA 18104
Phone (484) 503-4160

100 N Academy Ave
Danville, PA 17822

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

701 Ostrum St
Ste 503
Fountain Hill, PA 18015
Phone (484) 526-3950

701 Ostrum St
Ste 201
Fountain Hill, PA 18015
Phone (610) 868-1014

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

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5401 Old York Rd
Ste 5
Philadelphia, PA 19141
Phone (215) 456-6127

200 St Lukes Ln
Ste 100
Stroudsburg, PA 18360
Phone (484) 503-4600

1000 E Mountain Blvd
Wilkes Barre, PA 18711
Phone (570) 808-7399

Interoperability endpoints

  • Direct secure messaging: amylyn.mortimer@slpg.direct-sluhn.org

Organizations & group practices 11

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 10

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": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1760993638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST STE 503",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151153",
            "telephone_number": "484-526-3950",
            "fax_number": "484-526-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST STE 503",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151153",
            "telephone_number": "484-526-3950",
            "fax_number": "484-526-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTIMER",
        "first_name": "AMYLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-19",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hill, PA

Sources for this page

Verify at the official NPI Registry.