Amanda Kavanaugh, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA60938355 Issued in WA

Practice address

1201 S Miller St
Wenatchee, WA 98801-3201

Phone

(509) 663-8711

NPI assigned

Aug 9, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amanda Roy Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WA

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Washington Health Services AssociationGroup PAC ID 4880504596, 708 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Confluence Health Hospital Hospital, Wenatchee, WA, CCN 500016

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Central Washington Health Services Association

  • Emergency Medical Services (Emergency Medicine) Physician
  • Wenatchee, WA
  • NPI 1801937453
  Medicare reassignment Care Compare group
• Wenatchee Valley Hospital

  • Multi-Specialty Clinic/Center
  • Wenatchee, WA
  • NPI 1669719688
  Medicare reassignment NPD
• Wenatchee Valley Hospital

  • Clinical Medical Laboratory
  • Wenatchee, WA
  • NPI 1689916819
  NPD
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Joplin, MO
  • NPI 1538151733
  NPD (past)

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

• Central Washington Health Services Association

  • General Acute Care Hospital
  • Wenatchee, WA
  • NPI 1306883228
  Care Compare affiliation

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1861047425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MILLER ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013201",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "AMANDA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-09",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60938355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "1201 S Miller St",
            "city": "Wenatchee",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988013201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aroy48888@edirect.chehr.org",
            "affiliation": "N",
            "address_1": "1201 S Miller St",
            "city": "Wenatchee",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988013201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ROY",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew L Karr
• Amanda Lee Karschnick, ARNP
• Steven R Kaster, MD
• Valerie Diane Kato, NP
• Hanspreet Kaur, MD
• Amy B Kaye
• Mary Arlene Keefer Osborne, SUPD
• Glen Douglas Keeffe, LMHC, MA
• Alison Keeler, RN
• Erin Keeley

• Surgical Physician Assistant in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.