Mandi Glynn Amburn, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA04670 Issued in TX

Practice address

2200 Park Bend Dr
Building 1 Suite 301
Austin, TX 78758-5387

Phone

(512) 339-0440

Fax

(512) 339-0454

NPI assigned

Sep 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. David'S Ortho Neuro and Rehab PLLCGroup PAC ID 5799948857, 60 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• St. David'S Ortho, Neuro and Rehab, PLLC

  • Orthopaedic Surgery Physician
  • Austin, TX
  • NPI 1669742755
  Medicare reassignment Care Compare group
• CSK Medical Partners

  • Physical Therapy Clinic/Center
  • Lubbock, TX
  • NPI 1467576793
  NPD (past)
• Las Colinas Orthopedic Surgery and Sports Medicine P.a.

  • Specialist
  • Irving, TX
  • NPI 1952396996
  NPD (past)
• Neurotexas, PLLC

  • Neurological Surgery Physician
  • Austin, TX
  • NPI 1124214911
  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1780787986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 PARK BEND DR BLDG 1",
            "address_2": "SUITE 301",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585387",
            "telephone_number": "125-339-0440",
            "fax_number": "512-339-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 PARK BEND DR",
            "address_2": "BUILDING 1 SUITE 301",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585387",
            "telephone_number": "512-339-0440",
            "fax_number": "512-339-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBURN",
        "first_name": "MANDI",
        "middle_name": "GLYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2022-01-26",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10227",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA04670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00408065",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8N9216",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "517690000",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MANDI.AMBURN@hca8.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "2200 Park Bend Dr",
            "address_2": "BUILDING 1 SUITE 301",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787585387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Edwina Saplan Ambion, PT, DPT
• Mark S Ambler, MD
• Melynda Raena Ambriz
• Kevin Renz Ambrocio, M.S., CCC-SLP
• Audrey Marie Amburgey
• Luc Amdahl
• Hannah Merced Amedro
• Michelle Ameen
• Amelia Southwest Health
• Amelia Southwest Physicians

• Surgical Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.