Individual provider Active NPI

Amanda L Koch, NP

  • Nurse Practitioner
  • Dover, DE
National Provider Identifier
1831700533
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LG-0011462 Issued in DE
Practice address
540 S Governors Ave Ste 100
Dover, DE 19904-3530
Phone
(302) 526-1470
Fax
(302) 674-1398
NPI assigned
Aug 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LG-0011462 DE
Nurse Practitioner 363L00000X LG-0011462 DE Primary

Addresses

Primary practice location

540 S Governors Ave Ste 100
Dover, DE 19904-3530

Mailing address

640 S State Street, Mail Code 3055
Dover, DE 19901-3530
Phone (302) 480-1688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20210121000339 DE Practitioner - Nurse Practitioner 9436563186 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayhealth Medical Center, IncGroup PAC ID 1658364740, 399 clinicians

Practice addresses (Care Compare)

640 S State St
Dover, DE 19901-3530

Hospital & facility affiliations

  • Bayhealth Medical Center, Kent Campus Hospital, Dover, DE, CCN 080004
  • Bayhealth Hospital, Sussex Campus Hospital, Milford, DE, CCN 080009
  • Christiana Hospital Hospital, Newark, DE, CCN 080001
  • Beebe Medical Center Hospital, Lewes, DE, CCN 080007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc CurrentSince Feb 15, 2021 Accepting new patients
Bayhealth Medical Center, Inc. CurrentSince Feb 15, 2021 Accepting new patients
Bayhealth Medical Center, Inc. CurrentSince Feb 15, 2021 Accepting new patients
Bayhealth Medical Center, Inc Past Accepting new patients
Bayhealth Medical Center, Inc. Past Accepting new patients

Locations

540 S Governors Ave
Ste 100
Dover, DE 19904
Phone (302) 526-1470

640 S State St
#3055
Dover, DE 19901
Phone (302) 480-1688

640 S State St
Dover, DE 19901
Phone (302) 744-4700

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

101 Wellness Way
Ste 250
Milford, DE 19963
Phone (302) 744-6220

18383 Hudson Rd
Ste B
Milton, DE 19968
Phone (302) 725-3499

18383 Hudson Rd
#2
Milton, DE 19968

Organizations & group practices 17

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.

View all 17

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": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1831700533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S STATE STREET, MAIL CODE 3055",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-480-1688",
            "fax_number": "302-480-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 S GOVERNORS AVE STE 100",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199043530",
            "telephone_number": "302-526-1470",
            "fax_number": "302-674-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-14",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0011462",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0011462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.