Individual provider Active NPI

Amanda Mason, PA-C

  • Physician Assistant
  • Lansing, MI
National Provider Identifier
1770919649
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006824 Issued in MI
Practice address
1200 E Michigan Ave Ste 325
Lansing, MI 48912-1894
Phone
(517) 364-5160
NPI assigned
Sep 23, 2013
Last updated
Jun 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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 5601006824 MI Primary

Addresses

Primary practice location

1200 E Michigan Ave Ste 325
Lansing, MI 48912-1894

Mailing address

PO Box 13008
Lansing, MI 48901-3008

Other identifiers 1

IdentifierTypeStateIssuer
5601006824OtherMIMICHIGAN PHYSICIAN ASSISTANT LICENSE NUMBER

Other names 1

  • Amanda Albert Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20131216000758 MI Practitioner - Physician Assistant 2163659392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1200 E Michigan Ave
Lansing, MI 48912-1838

1200 E Michigan Ave
Lansing, MI 48912-1894

1200 E Michigan Ave Lowr Level
Sparrow Pain Management Center
Lansing, MI 48912-1800
Phone (517) 364-5330

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601006824MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W. Sparrow Hospital Association CurrentSince Oct 2, 2013 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Oct 2, 2013 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Apr 1, 2019 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

2900 Hannah Blvd
Ste 216
East Lansing, MI 48823
Phone (517) 364-8001

1200 E Michigan Ave
Ste 325
Lansing, MI 48912
Phone (517) 364-5160

1200 E Michigan Ave
Ste 775
Lansing, MI 48912
Phone (517) 364-5160

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1770919649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13008",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489013008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVE STE 325",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121894",
            "telephone_number": "517-364-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN PHYSICIAN ASSISTANT LICENSE NUMBER",
            "identifier": "5601006824",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ALBERT",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.