Individual provider Active NPI

Amanda Marie McClendon, PAC

  • Physician Assistant
  • Wynnewood, PA
National Provider Identifier
1831427228
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA054154 Issued in PA
Practice address
100 E Lancaster Ave
Heart Pavilion, Mezzanine
Wynnewood, PA 19096-3450
Phone
(484) 476-1000
Fax
(484) 476-9000
NPI assigned
Nov 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA054154 PA Primary

Addresses

Primary practice location

100 E Lancaster Ave
Heart Pavilion, Mezzanine
Wynnewood, PA 19096-3450

Mailing address

100 E Lancaster Ave
Heart Pavilion, Mezzanine
Wynnewood, PA 19096-3450
Phone (484) 476-1000

Other names 1

  • Amanda Parkhurst Former name

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091223000088 PA Practitioner - Physician Assistant 8527108588 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450

3855 W Chester Pike
Newton Square, PA 19073-2304

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Sep 3, 2012 Accepting new patients
Pinnacle Health Medical Services CurrentSince Sep 3, 2012 Accepting new patients

Locations

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282

1995 Technology Pkwy
Mechanicsburg, PA 17050
Phone (717) 791-2600

Organizations & group practices 4

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 4

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": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1831427228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "HEART PAVILION, MEZZANINE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-1000",
            "fax_number": "484-476-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "HEART PAVILION, MEZZANINE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-1000",
            "fax_number": "484-476-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENDON",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-24",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "PARKHURST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.