Individual provider Active NPI

Amanda J. Lewis, NPP

  • Psychiatric/Mental Health Nurse Practitioner
  • Batavia, NY
National Provider Identifier
1790072965
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401378-1 Issued in NY
Practice address
5130 E Main St Ste 2
Batavia, NY 14020-3444
Phone
(585) 344-1421
Fax
(585) 345-3080
NPI assigned
Jul 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F401378-1 NY Primary

Addresses

Primary practice location

5130 E Main St Ste 2
Batavia, NY 14020-3444

Mailing address

56 Beresford Rd
Rochester, NY 14610-1903

Other practice location 1

490 E Ridge Rd
Rochester, NY 14621-1229
Phone (585) 922-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20110907000852 NY Practitioner - Nurse Practitioner 0244400976 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of Genesee County TreasurerGroup PAC ID 2961398060, 14 clinicians

Practice addresses (Care Compare)

5130 E Main St Rd
Suite 2
Batavia, NY 14020-3496
Phone 58534414216610

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F401378-1NYMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1790072965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 BERESFORD RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146101903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 E MAIN ST STE 2",
            "city": "BATAVIA",
            "state": "NY",
            "postal_code": "140203444",
            "telephone_number": "585-344-1421",
            "fax_number": "585-345-3080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "490 E Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146211229",
            "country_code": "US",
            "telephone_number": "585-922-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "AMANDA",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "NPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-07",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401378-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, NY

Sources for this page

Verify at the official NPI Registry.