Individual provider Active NPI

Amanda Simmen

  • Clinical Social Worker
  • Monroeville, PA
National Provider Identifier
1780280867
Registry record updated Dec 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW021279 Issued in PA
Practice address
2540 Monroeville Blvd
Monroeville, PA 15146-2329
Phone
(412) 823-5155
NPI assigned
Dec 5, 2020
Last updated
Dec 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW021279 PA Primary

Addresses

Primary practice location

2540 Monroeville Blvd
Monroeville, PA 15146-2329

Mailing address

2540 Monroeville Blvd
Monroeville, PA 15146-2329
Phone (412) 823-5155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201216001684 PA Practitioner - Clinical Social Worker 3678985686 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW021279PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Persoma P.C. CurrentSince Dec 11, 2020 Accepting new patients

Locations

2540 Monroeville Blvd
Monroeville, PA 15146
Phone (412) 206-1411

300 Oxford Dr
Ste 110
Monroeville, PA 15146
Phone 4128235155801

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1607126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607126400000",
    "number": "1780280867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 MONROEVILLE BLVD",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462329",
            "telephone_number": "412-823-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 MONROEVILLE BLVD",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462329",
            "telephone_number": "412-823-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMEN",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-05",
        "last_updated": "2020-12-05",
        "certification_date": "2020-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW021279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

Verify at the official NPI Registry.