Amanda Maureen Jordan, PHYSICIAN ASSISTANT

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

031114 Issued in NY

Practice address

621 10TH St
Niagara Falls, NY 14301-1813

Phone

(716) 517-5436

NPI assigned

Jun 22, 2024

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

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/

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.

• Niagara Falls Memorial Medical Center

  • General Acute Care Hospital
  • Niagara Falls, NY
  • NPI 1285717298
  Medicare reassignment NPD
• Niagara Falls Memorial Medical Center

  • Obstetrics & Gynecology Physician
  • Niagara Falls, NY
  • NPI 1982659256
  Medicare reassignment
• Niagara Falls Memorial Medical Center

  • Oncology Clinic/Center
  • Niagara Falls, NY
  • NPI 1144842816
  NPD

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

{
    "created_epoch": "1719014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1861236036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 LIGHTHOUSE PT",
            "city": "GRAND ISLAND",
            "state": "NY",
            "postal_code": "140722267",
            "telephone_number": "716-517-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 10TH ST",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143011813",
            "telephone_number": "716-517-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "AMANDA",
        "middle_name": "MAUREEN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-22",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "031114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hanna Leigh Johnson
• Jessica Marie Johnson
• Keith W. Johnson Sr.
• Kimberly Michele Johnson
• Mbwana Mwai Samuel Johnson, MS, CRC, CASAS
• Ka-Shara Jordon, LMSW
• Teresa Ann Josey, MS
• Ryan Alfred Joyce, PT,DPT,CSCS
• Julie Kacz, DNP, FNP
• Anthony Kahley, BS, ATS

• Surgical Physician Assistant in Niagara Falls, NY
• Providers in Niagara Falls, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.