NPIMap

Individual provider Active NPI

Amanda Moran, CRNP

  • Nurse Practitioner
  • Dallas, PA
National Provider Identifier
1952843211
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP016595 Issued in PA
Practice address
114 LT Michael Cleary Dr
Dallas, PA 18612-1649
Phone
(570) 255-1178
Fax
(570) 255-1156
NPI assigned
Nov 17, 2016
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP016595 PA Primary
Family Nurse Practitioner 363LF0000X SP016595 PA

Addresses

Primary practice location

114 LT Michael Cleary Dr
Dallas, PA 18612-1649

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other practice location 1

575 N River St
Wilkes Barre, PA 18764-0999
Phone (570) 552-1003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170111000184 PA Practitioner - Nurse Practitioner 0244511947 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

114 LT Michael Cleary Dr
Dallas, PA 18612-1649
Phone (570) 255-1178

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP016595PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Aug 7, 2022 Accepting new patients
Schuylkill Health System Medical Group, Inc. CurrentSince Nov 1, 2019 Accepting new patients
Pennsylvania Physician Services, LLC CurrentSince Nov 9, 2016 Accepting new patients
Pennsylvania Physician Services, LLC CurrentSince Nov 9, 2016 Accepting new patients
Lehigh Valley Physician Group CurrentSince Apr 23, 2018 Accepting new patients
Geisinger Clinic Nurse Practitioner Current Accepting new patients
Lehigh Valley Physician Group Nurse Practitioner Current Accepting new patients
Pennsylvania Physician Services, LLC Current Accepting new patients
Geisinger Clinic CurrentSince Aug 7, 2022 Accepting new patients
Schuylkill Health System Medical Group, Inc. Family CurrentSince Nov 1, 2019 Accepting new patients
Lehigh Valley Physician Group CurrentSince Apr 23, 2018 Accepting new patients
Geisinger Clinic GYN Onc Nurse Practitioner Past Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

114 Lt Michael Cleary Dr
Dallas, PA 18612
Phone (570) 255-1178

100 N Academy Ave
Danville, PA 17822

700 E Broad St
Hazleton, PA 18201
Phone (570) 501-4000

560 Pierce St
Kingston, PA 18704
Phone (570) 283-2161

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

2128 Blakeslee Boulevard Dr E
Lehighton, PA 18235
Phone (484) 224-9970

128 E Main St
Nanticoke, PA 18634
Phone (570) 258-1304

42 N Main St
Pittston, PA 18640
Phone (570) 602-5610

200 Schuylkill Medical Plz
Pottsville, PA 17901
Phone (570) 621-9200

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

3 W Olive St
Scranton, PA 18508
Phone (570) 207-4054

746 Jefferson Ave
Scranton, PA 18510
Phone (570) 340-5079

1020 Northern Blvd
South Abington Township, PA 18411
Phone (570) 587-2290

631 Northern Blvd
South Abington Township, PA 18411
Phone (570) 340-6920

10 Trieble Dr
Tunkhannock, PA 18657
Phone (570) 996-2700

809 Hunter Hwy
Tunkhannock, PA 18657
Phone (570) 966-2700

25 Church St
Wilkes Barre, PA 18702
Phone (570) 340-5800

35 S Mountain Blvd
Wilkes Barre, PA 18707
Phone (570) 474-5072

575 N River St
Wilkes Barre, PA 18764
Phone (570) 552-1300

Interoperability endpoints

  • Direct secure messaging: amoran502279@direct.geisinger.edu
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1952843211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 LT MICHAEL CLEARY DR",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186121649",
            "telephone_number": "570-255-1178",
            "fax_number": "570-255-1156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "575 N River St",
            "address_purpose": "LOCATION",
            "city": "Wilkes Barre",
            "state": "PA",
            "postal_code": "187640999",
            "country_code": "US",
            "telephone_number": "570-552-1003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-17",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP016595",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP016595",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, PA

Sources for this page

Verify at the official NPI Registry.