Individual provider Active NPI

Amanda Aman, MD

  • Family Medicine Physician
  • Nampa, ID
National Provider Identifier
1902428634
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M-16422 Issued in ID
Practice address
9850 W St Lukes Dr # 329
Nampa, ID 83687-7912
Phone
(085) 142-5092
Fax
(208) 375-2217
NPI assigned
May 15, 2020
Last updated
Dec 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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 M-16422 ID Primary

Addresses

Primary practice location

9850 W St Lukes Dr # 329
Nampa, ID 83687-7912

Mailing address

777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20230731002366 ID Practitioner - Family Practice 5496178816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Full Circle Health IncGroup PAC ID 6709986797, 106 clinicians

Practice addresses (Care Compare)

9850 W St Lukes Dr
Suite 329
Nampa, ID 83687-7912
Phone (208) 514-2509

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-16422IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Full Circle Health, Inc. CurrentSince Aug 7, 2023 Accepting new patients

Locations

777 N Raymond St
Boise, ID 83704
Phone (208) 367-6030

9850 W St Lukes Dr
#329
Nampa, ID 83687
Phone (208) 514-2509

9850 W St Lukes Dr
Ste 329
Nampa, ID 83687
Phone (208) 331-1155

Interoperability endpoints

  • Direct secure messaging: aaman310780@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1902428634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N RAYMOND ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049251",
            "telephone_number": "208-514-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 W ST LUKES DR # 329",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836877912",
            "telephone_number": "085-142-5092",
            "fax_number": "208-375-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAN",
        "first_name": "AMANDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-16422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.