Individual provider Active NPI

Amanda Lynn Schaeffer, PA-C

  • Physician Assistant
  • Williamsburg, VA
National Provider Identifier
1790446409
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110008745 Issued in VA
Practice address
5424 Discovery Park Blvd Building a
Suite 201
Williamsburg, VA 23188
Phone
(757) 345-2071
NPI assigned
Jan 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 0110008745 VA Primary

Addresses

Primary practice location

5424 Discovery Park Blvd Building a
Suite 201
Williamsburg, VA 23188

Mailing address

5424 Discovery Park Boulevard Building a
Suite 201
Williamsburg, VA 23188
Phone (757) 345-2071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20220901003611 VA Practitioner - Physician Assistant 3678957016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidewater Physicians Multispecialty Group, PCGroup PAC ID 2860398526, 259 clinicians

Practice addresses (Care Compare)

4125 Ironbound Rd
Suite 200
Williamsburg, VA 23188-2666
Phone (757) 345-2829

5424 Discovery Park Blvd
Williamsburg, VA 23188-2862

860 Omni Blvd
Newport News, VA 23606-4430

Hospital & facility affiliations

  • Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Sep 1, 2022 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Sep 1, 2022 Accepting new patients

Locations

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

827 Diligence Dr
Ste 100
Newport News, VA 23606

11761 Rock Landing Dr
Ste 8
Newport News, VA 23606

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

860 Omni Blvd
Ste 105
Newport News, VA 23606
Phone (757) 873-0952

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1790446409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5424 DISCOVERY PARK BOULEVARD BUILDING A",
            "address_2": "SUITE 201",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "23188",
            "telephone_number": "757-345-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5424 DISCOVERY PARK BLVD BUILDING A",
            "address_2": "SUITE 201",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "23188",
            "telephone_number": "757-345-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFFER",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.