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AMANDA WIDMAR RDN
NPI 1124964424
Dietitian, Registered in Mesa, AZ

Active since April 28, 2026
1432 S DOBSON RD STE 107, MESA, AZ 85202(480) 681-4453 Get Directions Write a Review

NPPES record last updated: April 28, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Amanda Widmar Rdn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA WIDMAR RDN (NPI 1124964424) is an individual dietitian, registered in Mesa, Arizona and active in the NPI registry since April 2026. She is a graduate of Other (2025).

NPPES Registry Identity

NPI1124964424
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameAMANDA WIDMARCredential: RDN
Location Address1432 S DOBSON RD STE 107Mesa, AZ 85202-4769
Mailing Address255 S Kyrene Rd Unit 133Chandler, AZ 85226-4490
Phone(480) 681-4453
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateApril 28, 2026
NPPES CertifiedApril 28, 2026
✔ NPI 1124964424 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
1432 S DOBSON RD STE 107, Mesa, AZ 85202
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Widmar Rdn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6305316233
PECOS Enrollment IDI20260601002566

Medicare Billing Reassignment

Medicare enrollment records show Amanda Widmar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Banner Physician Specialists Arizona LLC
13 mi
Multi-Specialty
2901 N CENTRAL AVE STE 160
Phoenix, AZ 85012
  • Reassigned Medicare billing, Arizona enrollment
  • 538 clinicians in this Medicare group
NPI 1033730429 (602) 747-4000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LOKESH KUMAR JHA MD
Internal Medicine (Gastroenterology)
1432 S DOBSON RD STE 107
MESA, AZ 85202
Maricopa County (480) 681-4453
MONICA DAHIYA-SIHOTA MD
Internal Medicine (Gastroenterology)
1432 S DOBSON RD STE 107
MESA, AZ 85202
Maricopa County (480) 681-4453
DAYNA CLINE RD
Dietitian, Registered (Nutrition, Pediatric)
1432 S DOBSON RD STE 107
MESA, AZ 85202
Maricopa County (480) 412-6783
DR. JOSEPH CHARLES TORKILDSON MD
Pediatrics (Pediatric Hematology-Oncology)
1432 S DOBSON RD STE 107
MESA, AZ 85202
Maricopa County (480) 412-4100
DR. SANTOSH S HANMOD M.D.
Pediatrics (Pediatric Hematology-Oncology)
1432 S DOBSON RD STE 107
MESA, AZ 85202
Maricopa County (480) 412-4100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amanda Widmar's NPI number?

The NPI number for Amanda Widmar is 1124964424. It was assigned to this individual provider in the NPPES registry on April 28, 2026.

Where is Amanda Widmar located?

Amanda Widmar practices at 1432 S Dobson Rd Ste 107, Mesa, AZ 85202. The listed phone number is (480) 681-4453.

What is Amanda Widmar's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Amanda Widmar enrolled in Medicare?

Yes. Amanda Widmar is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Amanda Widmar's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Widmar reassigns Medicare benefits to Banner Physician Specialists Arizona LLC (Phoenix, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Amanda Widmar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Amanda Widmar accept?

Health plans from Blue Cross Blue Shield of Arizona and Oscar Health Plan, Inc. list Amanda Widmar as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Amanda Widmar was last updated on April 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.