Amanda Marie Fellin, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA062795 Issued in NJ

Practice address

860 1St Ave Ste 8B
King of Prussia, PA 19406-4033

Phone

(844) 337-6362

Fax

(646) 665-3604

NPI assigned

Mar 1, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pennsylvania Centre for Dermatology, LLCGroup PAC ID 4183603335, 40 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Pennsylvania Centre for Dermatology, LLC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1861501801
  Medicare reassignment Care Compare group
• CDC Allentown, P.C.

  • Dermatology Physician
  • Allentown, PA
  • NPI 1164909933
  Medicare reassignment
• Complete Dermatology Center, P.C.

  • Dermatology Physician
  • Quakertown, PA
  • NPI 1871853234
  Medicare reassignment
• CDC Bethlehem, P.C.

  • Dermatology Physician
  • Bethlehem, PA
  • NPI 1255153581
  NPD (past)

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1851986996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4170 CITY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311610",
            "telephone_number": "215-871-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 1ST AVE STE 8B",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194064033",
            "telephone_number": "844-337-6362",
            "fax_number": "646-665-3604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4170 City Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191311610",
            "country_code": "US",
            "telephone_number": "215-871-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELLIN",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "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": "NJ",
            "license": "MA062795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Practice Associates of King of Prussia, P.C.
• Alina Fardella
• Kaitlyn Farrelly, MS, NCC
• Maria Febles
• Ryan Benjamin Feeney, PHARMD
• Heather Lynne Fenstermaker, M.ED., BCBA, LBS
• Meghan Logan Ferrari
• Jocelyn Ferraro
• Feta Med, Inc.
• First Avenue Occupational Medicine, LLC

• Physician Assistant in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.