Amanda Lariscey, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

122 Alice Coleman Drive
Vidalia, GA 30474

Phone

(912) 805-2273

NPI assigned

Aug 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vidalia Immediate and Primary Care LLCGroup PAC ID 8820489941, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Health Meadows Hospital Hospital, Vidalia, GA, CCN 110128

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Vidalia Immediate & Primary Care LLC

  • Primary Care Clinic/Center
  • Vidalia, GA
  • NPI 1942974167
  Medicare reassignment Care Compare group
• Optim Orthopedics, LLC

  • Orthopaedic Surgery Physician
  • Savannah, GA
  • NPI 1780077982
  Medicare reassignment
• Optim Orthopedics, LLC

  • Orthopaedic Surgery Physician
  • Jesup, GA
  • NPI 1467845404
  NPD
• Optim Orthopedics, LLC

  • Orthopaedic Surgery Physician
  • Brunswick, GA
  • NPI 1487047726
  NPD
• Cardiovascular Associates of Eastern Georgia

  • Specialist
  • Statesboro, GA
  • NPI 1518902147
  NPD (past)
• Optim Orthopedics, LLC

  • Orthopaedic Surgery Physician
  • Midway, GA
  • NPI 1821639758
  NPD (past)
• Optim Orthopedics, LLC

  • Orthopaedic Surgery Physician
  • Bluffton, SC
  • NPI 1528451481
  NPD (past)

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

• Vidalia Health Services, LLC

  • General Acute Care Hospital
  • Vidalia, GA
  • NPI 1790376564
  Care Compare affiliation

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1780164590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2324",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304752324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 ALICE COLEMAN DRIVE",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "30474",
            "telephone_number": "912-805-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARISCEY",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kurt P Hofmann MD LLC
• Mary Lesie Kyzer, PTA
• Jessica Leigh Langenfeld, FNP-C
• Lashonda Monique Lanier-Jenkins, REGISTERED NURSE
• Abbey Lanier, OTR/L
• Steven Michael Lashley, FNP
• Dana Brown Lawrence, OTRL
• Jennifer Michelle Lawrence, FNP
• Jill Nicole Lawrence, CCC/SLP
• Leigh-Anne White & Company

• Physician Assistant in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.