Amanda Marie Mattingley, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5601009055 Issued in MI

Practice address

2900 Hannah Blvd Ste 216
East Lansing, MI 48823

Phone

(517) 364-8100

NPI assigned

Mar 23, 2018

Last updated

Sep 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Edward W. Sparrow Hospital Association

  dba Sparrow Behavioral Health - Social Workers

  • Clinical Social Worker
  • Lansing, MI
  • NPI 1033165790
  Medicare reassignment
• Edward W Sparrow Hospital Association

  dba University of Michigan Health-Sparrow

  • Adult Health Nurse Practitioner
  • Lansing, MI
  • NPI 1265220438
  NPD

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1922502947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 HANNAH BLVD STE 216",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235382",
            "telephone_number": "517-364-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 HANNAH BLVD STE 216",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "48823",
            "telephone_number": "517-364-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLEY",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601009055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katia Hawatmeh Mashni
• Massage & Wellness
• Olivia Kristine Mastin
• Beena Mathew, PT
• Cheyenne Brooke Matson
• Emilia Elizabeth Mattioli, MD
• Bonnie Aline Matus, PTA
• Julie A Matyasic, P.A.
• Joseph Vincent Mauro, D.D.S.
• Dana Marie Maxwell, BCBA

• Surgical Physician Assistant in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Surgical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.