Individual provider Active NPI

Amanda Faye Northup, MD

  • Cardiovascular Disease Physician
  • Kapolei, HI
National Provider Identifier
1881033694
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35918 Issued in SC
Practice address
91-1051 Franklin D Roosevelt Ave
Kapolei, HI 96707-2185
Phone
(808) 458-5065
NPI assigned
Jun 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35918 SC Primary
Internal Medicine Physician 207R00000X LL35918 SC

Addresses

Primary practice location

91-1051 Franklin D Roosevelt Ave
Kapolei, HI 96707-2185

Mailing address

91-1051 Franklin D Roosevelt Ave
Kapolei, HI 96707-2185
Phone (808) 458-5064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190909003661 SC Practitioner - Cardiovascular Disease (Cardiology) 4789906454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Internal Medicine CurrentSince Jul 11, 2019 Accepting new patients
University Medical Associates of the Medical University of South Carol Cardiovascular Disease Current Accepting new patients
University Medical Associates CurrentSince Jul 11, 2019 Accepting new patients

Locations

169 Ashley Ave
Rm 202
Charleston, SC 29425
Phone (843) 792-0192

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Interoperability endpoints

  • Direct secure messaging: anorthup1196@direct.musc.edu

Organizations & group practices 3

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": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1881033694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-1051 FRANKLIN D ROOSEVELT AVE",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072185",
            "telephone_number": "808-458-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-1051 FRANKLIN D ROOSEVELT AVE",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072185",
            "telephone_number": "808-458-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHUP",
        "first_name": "AMANDA",
        "middle_name": "FAYE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "35918",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL35918",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapolei, HI

Sources for this page

Verify at the official NPI Registry.