NPIMap

Individual provider Active NPI

Amanda Rae Wholly, ANP

  • Women's Health Nurse Practitioner
  • Apo, NY
National Provider Identifier
1780052159
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
103809 Issued in AK
Practice address
Landstuhl Regional Medical Center Unit 33100
Apo, NY 09180-3100
Phone
(153) 590-7662
NPI assigned
Sep 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 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 103809 AK Primary

Addresses

Primary practice location

Landstuhl Regional Medical Center Unit 33100
Apo, NY 09180-3100

Mailing address

4001 Lake Otis Pkwy Ste 101
Anchorage, AK 99508-5200
Phone (800) 769-0045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20230626002282 AK Practitioner - Nurse Practitioner 3779941588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alaska Womens Cancer Care LLCGroup PAC ID 3971758319, 5 clinicians

Practice addresses (Care Compare)

3851 Piper St
Suite U264
Anchorage, AK 99508-6903
Phone (907) 562-4673

Hospital & facility affiliations

  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001
  • Mat-Su Regional Medical Center Hospital, Palmer, AK, CCN 020006
  • Alaska Regional Hospital Hospital, Anchorage, AK, CCN 020017
  • Central Peninsula General Hospital Hospital, Soldotna, AK, CCN 020024
  • Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012

Merit-based Incentive Payment System (MIPS)

Final score
60.62 of 100Reported as group
Quality
70.41
Promoting interoperability
86
Improvement activities
40
Cost
10

Merit-based Incentive Payment System (MIPS)

Final score
70.59 of 100Reported as group
Quality
83.37
Promoting interoperability
100
Improvement activities
40
Cost
16.65

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Women'S Cancer Care, LLC CurrentSince Jul 17, 2023 Accepting new patients

Locations

3851 Piper St
Ste U264
Anchorage, AK 99508
Phone (907) 334-6442

Organizations & group practices 1

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 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1780052159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 LAKE OTIS PKWY STE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085200",
            "telephone_number": "800-769-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100",
            "city": "APO",
            "state": "NY",
            "postal_code": "091803100",
            "telephone_number": "153-590-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHOLLY",
        "first_name": "AMANDA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AK",
            "license": "103809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apo, NY

Sources for this page

Verify at the official NPI Registry.