NPIMap

Individual provider Active NPI

Amanda Louise Fulmore, PA-C

  • Physician Assistant
  • Easton, PA
National Provider Identifier
1942580022
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA002708 Issued in PA
Practice address
1600 St Lukes Blvd
Easton, PA 18045-5671
Phone
(484) 503-4500
Fax
(484) 503-4501
NPI assigned
Aug 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA002708 PA Primary

Addresses

Primary practice location

1600 St Lukes Blvd
Easton, PA 18045-5671

Mailing address

1600 St Lukes Blvd
Easton, PA 18045-5671
Phone (484) 503-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160425000065 PA Practitioner - Physician Assistant 4981831468 Reassigns benefits to 1 organization
I20170228002483 NJ Practitioner - Physician Assistant 4981831468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

240 Cetronia Rd
Allentown, PA 18104-9263

240 Cetronia Rd 205
St Luke'S Weight Management Center
Allentown, PA 18104-9263
Phone (484) 426-2600

240 Cetronia Rd 210a
St Lukes Neurology Associates
Allentown, PA 18104-9263
Phone (484) 426-2626

701 Ostrum St
Fountain Hill, PA 18015-1153

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • St Luke'S Hospital - Upper Bucks Campus Hospital, Quakertown, PA, CCN 390035
  • St Luke'S Hospital - Monroe Campus Hospital, Stroudsburg, PA, CCN 390330
  • Geisinger St. Luke'S Hospital Hospital, Orwigsburg, PA, CCN 390332
  • St Luke'S Miners Memorial Hospital Hospital, Coaldale, PA, CCN 390183

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OA002708PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Warren Physician Group, PC CurrentSince Dec 18, 2016 Accepting new patients
St. Luke'S Warren Physician Group, PC CurrentSince Dec 18, 2016 Accepting new patients
St. Luke'S Physician Group, Inc. CurrentSince Apr 25, 2016 Accepting new patients
St Luke'S Physician Group Inc CurrentSince Apr 25, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
St. Luke'S Physician Group, Inc Past Accepting new patients

Locations

279 State Route 31 S
Washington, NJ 07882
Phone (908) 689-2201

315 State Route 31 S
Washington, NJ 07882
Phone (908) 689-0777

1600 St Lukes Blvd
Easton, PA 18045
Phone (484) 503-4400

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Interoperability endpoints

  • Direct secure messaging: amanda.fulmore@slpg.direct-sluhn.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1942580022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 ST LUKES BLVD",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180455671",
            "telephone_number": "484-503-4500",
            "fax_number": "484-503-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ST LUKES BLVD",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180455671",
            "telephone_number": "484-503-4500",
            "fax_number": "484-503-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULMORE",
        "first_name": "AMANDA",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA002708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, PA

Sources for this page

Verify at the official NPI Registry.