Individual provider Active NPI

Amanda S Dalaska, ARNP

  • Family Nurse Practitioner
  • Clinton, IA
National Provider Identifier
1962750422
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A122875 Issued in IA
Practice address
221 Main Ave
Clinton, IA 52732-2241
Phone
(563) 242-7522
Fax
(563) 242-7534
NPI assigned
Aug 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A122875 IA Primary
Family Nurse Practitioner 363LF0000X 277003813 IL

Addresses

Primary practice location

221 Main Ave
Clinton, IA 52732-2241

Mailing address

PO Box 4028
Rock Island, IL 61204-4028
Phone (563) 355-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121116000249 IA Practitioner - Nurse Practitioner 7012168206 Reassigns benefits to 1 organization
I20141002001561 IL Practitioner - Nurse Practitioner 7012168206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians

Practice addresses (Care Compare)

1520 W 53Rd St
Mercyone Genesis Northwest Convenie
Davenport, IA 52806-2459
Phone (563) 421-3800

301 N 4TH Ave
Mercyone Genesis Eldridge
Eldridge, IA 52748-1113
Phone (563) 421-9880

3200 W Kimberly Rd
Davenport, IA 52806-3059
Phone (563) 421-0100

4321 53Rd Ave
Bettendorf, IA 52722-1269
Phone (563) 421-5300

619 5TH St
Durant, IA 52747-7737
Phone (563) 785-4487

Hospital & facility affiliations

  • Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A122875IAMDFamily Nurse Practitioner
277003813ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Specialty Clinic Past Accepting new patients
Genesis Health System Past Accepting new patients

Organizations & group practices 4

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 1

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": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1962750422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4028",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612044028",
            "telephone_number": "563-355-9200",
            "fax_number": "563-355-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 MAIN AVE",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527322241",
            "telephone_number": "563-242-7522",
            "fax_number": "563-242-7534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALASKA",
        "first_name": "AMANDA",
        "middle_name": "S",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-15",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A122875",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277003813",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

Verify at the official NPI Registry.