NPIMap

Individual provider Active NPI

Amanda Vitko, M.D.

  • Family Medicine Physician
  • Leominster, MA
National Provider Identifier
1902193444
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
257851 Issued in MA
Practice address
225 New Lancaster Road
Leominster, MA 01453-4958
Phone
(978) 466-3208
Fax
(978) 840-1680
NPI assigned
Jul 6, 2011
Last updated
Dec 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 257851 MA Primary

Addresses

Primary practice location

225 New Lancaster Road
Leominster, MA 01453-4958

Mailing address

5 Neponset St FL Street2
Worcester, MA 01606-2714
Phone (978) 466-3208

Other practice location 1

279 Lincoln St
Worcester, MA 01605-2120
Phone (508) 334-8830

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140917001281 MA Practitioner - Family Practice 7719106103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tulane University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

101 Cedar St
Milford, MA 01757-1101
Phone (508) 634-3100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Family Medicine CurrentSince Dec 10, 2018 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

225 New Lancaster Rd
Leominster, MA 01453
Phone (978) 466-3208

101 Cedar St
Milford, MA 01757
Phone (508) 634-5000

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
#2
Worcester, MA 01606

Interoperability endpoints

  • Direct secure messaging: amanda.vitko.npi1902193444.reliant@direct.optumcare.masshiway.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1902193444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST FL STREET2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "978-466-3208",
            "fax_number": "978-840-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 NEW LANCASTER ROAD",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014534958",
            "telephone_number": "978-466-3208",
            "fax_number": "978-840-1680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "279 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052120",
            "country_code": "US",
            "telephone_number": "508-334-8830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VITKO",
        "first_name": "AMANDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "257851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.