Amanda Matje PA-C PLLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

AMANDA MATJE PA-C PLLC

Practice address

7600 N 15TH St
Phoenix, AZ 85020-4327

Phone

(602) 395-0718

NPI assigned

May 5, 2022

Last updated

May 5, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vanessa Koziol

Title

Credentialing

Phone

(480) 376-6456

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Frances Matje, PA-C

  • Physician Assistant
  • Flagstaff, AZ
  • NPI 1821321969
  Medicare reassignment
• Shiona Marie Smith, PA-C

  • Surgical Physician Assistant
  • Peoria, AZ
  • NPI 1841957412
  NPD (past)

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1962148791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39179",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850699179",
            "telephone_number": "602-395-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 N 15TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204327",
            "telephone_number": "602-395-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA MATJE PA-C PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "KOZIOL",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "480-376-6456"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEND",
            "identifier": "PEND",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@eamedbill.com",
            "affiliation": "N",
            "address_1": "7600 N 15th St",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850204327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanah Health
• Amanah Health, LLC
• Amanah Medical Transport LLC
• Frances Amanati
• Amanda Girardi
• Amani Integrated Treatment Center LLC
• Iheanyi Nnamdi Amanwanne, NP PSYCH
• Surabhi Amar, M.D.
• Alice Mustapha Amara, ACNP
• Jason Zarahi Amaral, MD

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.