Amanda M Bryant
Individual provider Active NPI Family Nurse Practitioner · Wilbraham, MA
NPI 1912436619 · NPPES record last updated Dec 28, 2017
Key facts
- NPI
- 1912436619
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2294531 (MA)
- Practice address
- 70 PST Office Park
Wilbraham, MA 01095 - Phone
- (413) 598-7770
- NPI assigned
- Jun 6, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171012001662 | MA | Practitioner - Nurse Practitioner | 5496020760 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2294531 | MA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverbend Medical Group, Inc | Current |
Accepting new patients | |
| Riverbend Medical Group, Inc. | Current |
Accepting new patients | |
| Riverbend Medical Group, Inc | Past | Accepting new patients | |
| Mwa,PC | Past | Accepting new patients |
Locations
444 Montgomery St
Chicopee, MA 01020
Phone (413) 594-3111
271 Carew St
Springfield, MA 01104
Phone (413) 748-9000
395 Southampton Rd
Ste 100
Westfield, MA 01085
Phone (413) 485-4661
70 Post Office Park
Wilbraham, MA 01095
Phone (413) 596-3881
Interoperability endpoints
- abryant2389676@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2294531 | MA | Yes |
Addresses
Primary practice location
70 PST Office Park
Wilbraham, MA 01095
Mailing address
70 Post Office Park
Wilbraham, MA 01095-1290
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110126974A | Medicaid | MA |
Other providers in Wilbraham, MA
- Valerie Brach-Bonkowski
- Tyler Joseph Branco
- Adriana Brooks
- Lisa Beth Brosnan
- Lindsey Brunette
- Laurie Dasso Butler
- Celsea Caisse
- Molly Caltabiano
- Daniel Cardinal
- Alyssa Marie Charbonneau
All providers in Wilbraham, MA · Family Nurse Practitioner in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.