Individual provider Active NPI

Amanda Marie Stewart, PA-C

  • Physician Assistant
  • Independence, IA
National Provider Identifier
1871237362
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
121759 Issued in IA
Practice address
2277 Iowa Ave
Independence, IA 50644-9106
Phone
(319) 334-2583
Fax
(319) 334-5204
NPI assigned
Apr 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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 121759 IA Primary

Addresses

Primary practice location

2277 Iowa Ave
Independence, IA 50644-9106

Mailing address

2277 Iowa Ave
Independence, IA 50644-9106
Phone (319) 334-2583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20240118001844 IA Practitioner - Physician Assistant 1355793068 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
121759IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Institute CurrentSince Dec 6, 2023 Accepting new patients

Locations

2277 Iowa Ave
Independence, IA 50644
Phone (319) 334-2583

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1871237362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2277 IOWA AVE",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506449106",
            "telephone_number": "319-334-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 IOWA AVE",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506449106",
            "telephone_number": "319-334-2583",
            "fax_number": "319-334-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "121759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, IA

Sources for this page

Verify at the official NPI Registry.