AMANDA M MASTROFINI (NPI# 1285118919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285118919 |
| Entity Type | Individual |
| Full Name | AMANDA M MASTROFINI |
| Credential | NP |
| Practice Address |
3577 W 13 Mile Rd Ste 204 Royal Oak MI 48073-6710 |
| Mailing Address |
29992 Northwestern Hwy Ste C Farmington Hills MI 48334-3292 |
| Practice Telephone | 2485512446 |
| Practice Fax Number | 2485511094 |
| Mailing Telephone | 2488511430 |
| Mailing Fax Number | 2488515182 |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2018-12-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
4704288346 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | STATE LICENSE | 4704288346 | 01 |
| MI | MEDICARE PROVIDER NUMBER | MI4989654 | 01 |
| MI | 1285118919 | 05 |
| Street Address |
3577 W 13 MILE RD STE 204 |
| City | ROYAL OAK |
| State | MI |
| Zip Code | 48073-6710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720529035 | Stephani L Fleezanis | Nurse Practitioner | 3577 W 13 Mile Rd Ste 204, Royal Oak, MI 48073-6710 | 2017-03-20 |
| 1528578952 | Emily Anne Raymond | Physician Assistant | 3577 W 13 Mile Rd Ste 204, Royal Oak, MI 48073 | 2017-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891306114 | Spine and Joint Surgical Institute of Michigan, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 200, Royal Oak, MI 48073 | 2020-08-11 |
| 1528679081 | Activo Physical Therapy, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 101, Royal Oak, MI 48073 | 2020-08-10 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
| 1598389785 | Devika Aggarwal | Internal Medicine | 3601 W 13 Mile Road Beaumont Hospital- Royal Oak, Royal Oak, MI 48073 | 2020-06-03 |
| 1831713064 | Michael Morelli | Physical Medicine & Rehabilitation | Department of Physical Medicine and Rehabilitation, 3601 W 13 Mile Road, Royal Oak, MI 48073 | 2020-06-03 |
| 1134741895 | Kamil Sardarli | Internal Medicine | Beaumont Hospital - Royal Oak 3601 W Thirteen Mile Road, Royal Oak, MI 48073 | 2020-05-15 |
| 1245850171 | Dema Fawaz | Emergency Medicine | Beaumont Hospital, Royal Oak, Gme Office, 3601 W. 13 Mile Rd, Royal Oak, MI 48073 | 2020-04-21 |
| 1235771049 | Semaan Dentistry Pllc | Dentist | 30955 Woodward Ave Ste 105, Royal Oak, MI 48073 | 2019-10-14 |
| 1013560473 | Muhammad Waqas | Pediatrics | Beaumont Hospital Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI 48073 | 2019-07-24 |
| 1346804135 | Matthew M Astolfi | Orthopaedic Surgery | 3601 W Thirteenth Mile Road, Royal Oak, MI 48073 | 2019-04-26 |
| Find all providers in zip 48073 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245693126 | Alla Zabegaylo | Nurse Practitioner | 221 S Main St Ste 201, Royal Oak, MI 48067-2653 | 2016-03-30 |
| 1528076973 | Marilyn Chrisman | Nurse Practitioner | 3601 W 13 Mile Rd, Fsc, Royal Oak, MI 48073-6712 | 2006-08-03 |
| 1972518678 | Debra Jean Lontorfos | Nurse Practitioner | 3601 W 13 Mile Rd, Fsc, Royal Oak, MI 48073-6712 | 2006-07-30 |
| 1881609584 | Stephanie A. Lusis | Nurse Practitioner | 3601 W 13 Mile Rd, Fsc, Royal Oak, MI 48073-6712 | 2006-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942800768 | Yuri L Guzman | Nurse Practitioner | 795 N Ford Blvd, Ypsilanti, MI 48198-4116 | 2020-10-30 |
| 1144830803 | Robert Eugene Scribner IIi | Nurse Practitioner | 13913 Toepfer Rd, Warren, MI 48089-5842 | 2020-08-06 |
| 1124644661 | Denika Leflora Dalton | Nurse Practitioner | 5260 Fairway Trl, Grand Blanc, MI 48439-9445 | 2020-06-21 |
| 1780206995 | Jennifer Kay Marino | Nurse Practitioner | 20407 Mauer St, Saint Clair Shores, MI 48080-3789 | 2020-05-11 |
| 1720621709 | Kelsey Nicole Kloosterman | Nurse Practitioner | Susan P. Wheatlake Regional Cancer Center, 4499 220th Ave, Reed City, MI 49677 | 2019-10-23 |
| 1558911842 | Jomy Jose | Nurse Practitioner | 25719 Salem St, Roseville, MI 48066 | 2019-09-18 |
| 1306318498 | Ashley Marie Jacobson | Nurse Practitioner | 4100 Lake Dr Se Ste D, Grand Rapids, MI 49546-8292 | 2018-12-30 |
| 1568931673 | Jennifer Lavigne | Nurse Practitioner | 145 Michigan St Ne Ste 3300, Grand Rapids, MI 49503-2562 | 2018-11-19 |
| 1134694292 | Sheryl Ann Newton | Nurse Practitioner | 810 W South St, Kalamazoo, MI 49007-4601 | 2018-10-04 |
| 1386123180 | Alison M Sesock | Nurse Practitioner | 5202 Miller Rd Ste B, Flint, MI 48507-1040 | 2018-08-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.