Active NPI
Amanda Petroski, CSA
- Surgical Assistant
- Norfolk, VA
National Provider Identifier
1932722626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 5148
- Practice address
- 601 Childrens LN
Norfolk, VA 23507-1910 - Phone
- (757) 668-7000
- NPI assigned
- May 28, 2020
- Last updated
- May 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 5148 | VA | Primary |
Addresses
Primary practice location
601 Childrens LN
Norfolk, VA 23507-1910
Mailing address
111 Manning Rd Apt B
Suffolk, VA 23434-6537
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5148 | VA | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590624000000",
"number": "1932722626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 MANNING RD APT B",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234346537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 CHILDRENS LN",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235071910",
"telephone_number": "757-668-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROSKI",
"first_name": "AMANDA",
"credential": "CSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-28",
"last_updated": "2020-05-28",
"certification_date": "2020-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "VA",
"license": "5148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.