NPIMap

Individual provider Active NPI

Amanda Kristine Johnson, PA-C

  • Medical Physician Assistant
  • Pottsville, PA
National Provider Identifier
1902343429
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA058793 Issued in PA
Practice address
700 E Norwegian St
Pottsville, PA 17901-2710
Phone
(570) 621-4000
Fax
(570) 621-9213
NPI assigned
Jan 22, 2017
Last updated
Nov 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA058793 PA
Medical Physician Assistant 363AM0700X MA058793 PA Primary

Addresses

Primary practice location

700 E Norwegian St
Pottsville, PA 17901-2710

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Other practice location 1

171 Red Horse Rd
Pottsville, PA 17901-9119
Phone (570) 628-2229

Other names 1

  • Ms. Amanda Kristine Fisher Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20191218002075 PA Practitioner - Physician Assistant 2961836325 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.64 of 100Reported as group
Quality
76.75
Promoting interoperability
87
Improvement activities
40
Cost
74.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA058793PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Nov 4, 2024 Accepting new patients
Schuylkill Health System Medical Group, Inc. CurrentSince Nov 18, 2019 Accepting new patients
Lehigh Valley Physician Group CurrentSince Nov 4, 2024 Accepting new patients
Valley Health Partners Community Health Center Current Accepting new patients
Hazleton Professional Services CurrentSince Dec 18, 2023 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

1627 Chew St
Fl 1
Allentown, PA 18102
Phone (610) 969-2800

2100 Mack Blvd
Fl 4
Allentown, PA 18103

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

50 Moisey Dr
Ste 208
Hazle Township, PA 18202
Phone (570) 501-6380

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

237 S Mountain Blvd
Ste 7
Mountain Top, PA 18707
Phone (570) 261-5000

171 Red Horse Rd
Pottsville, PA 17901
Phone (570) 628-2229

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

224 Claremont Ave
Tamaqua, PA 18252
Phone (570) 628-2229

Organizations & group practices 9

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 2

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": "1485043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1902343429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E NORWEGIAN ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179012710",
            "telephone_number": "570-621-4000",
            "fax_number": "570-621-9213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Red Horse Rd",
            "address_purpose": "LOCATION",
            "city": "Pottsville",
            "state": "PA",
            "postal_code": "179019119",
            "country_code": "US",
            "telephone_number": "570-628-2229",
            "fax_number": "570-628-5182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMANDA",
        "middle_name": "KRISTINE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-22",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058793",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA058793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "FISHER",
            "middle_name": "KRISTINE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pottsville, PA

Sources for this page

Verify at the official NPI Registry.