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AMANDA LYNNE FAGAN D.O
NPI 1245617802
Family Medicine in Orlando, FL

Active since May 04, 2015PECOS Enrolled
4613 S ORANGE BLOSSOM TRL, ORLANDO, FL 32839(407) 232-9833(407) 232-9829 Get Directions Write a Review

NPPES record last updated: February 3, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 3, 2021, Oct 30, 2018 (2 updates tracked since 2018).

About Amanda Lynne Fagan D.o NPPES

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

AMANDA LYNNE FAGAN D.O (NPI 1245617802) is an individual family medicine provider in Orlando, Florida, licensed in Florida (OS17191) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245617802
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameAMANDA LYNNE FAGANCredential: D.O
Location Address4613 S ORANGE BLOSSOM TRLOrlando, FL 32839-1705
Mailing Address4613 S Orange Blossom TrlOrlando, FL 32839-1705 · (407) 232-9833 · Fax (407) 232-9829
Phone(407) 232-9833
Fax(407) 232-9829
Sole ProprietorNo
Enumeration DateMay 4, 2015
Last NPPES UpdateFebruary 3, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 3, 2021
✔ NPI 1245617802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in FL · OS17191✔ Licensed in NV · DO2319✔ Licensed in NV · SL1068
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4613 S ORANGE BLOSSOM TRL, Orlando, FL 32839
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Other Names 1

Former Name (1)Amanda Lynne Stuck

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Lynne Fagan D.o is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Amanda Fagan reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Dedicated Senior Medical Center Of Florida, LLC
70 mi
Specialist
1901 FLETCHER AVENUE
Tampa, FL 33612
  • Reassigned Medicare billing, Florida enrollment
  • 348 clinicians in this Medicare group
NPI 1700393881 (305) 628-6117
Southwest Medical Associates, Inc
2,034 mi
Internal Medicine
888 S RANCHO DR
Las Vegas, NV 89106
  • Reassigned Medicare billing, Nevada enrollment
  • 406 clinicians in this Medicare group
NPI 1659346005 (702) 877-8600
Optum Medical Group II Rhodes P C
2,039 mi
Internal Medicine
2704 N TENAYA WAY
Las Vegas, NV 89128
  • Reassigned Medicare billing, Nevada enrollment
  • 608 clinicians in this Medicare group
NPI 1790329407 (702) 877-5199

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32839 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

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

NATACHA SEIDU ARNP
Nurse Practitioner (Family)
4613 S ORANGE BLOSSOM TRL
ORLANDO, FL 32839
Orange County (407) 232-9833
DR. MICHAEL WARREN KAPLAN MD
Internal Medicine
4613 S ORANGE BLOSSOM TRL
ORLANDO, FL 32839
Orange County (407) 232-9833
MARYAM BAYATMOKHTARI
Family Medicine
4613 S ORANGE BLOSSOM TRL
ORLANDO, FL 32839
Orange County (407) 232-9833
DR. HEILEN PATRICIA BRAVO BRAVO MD
Internal Medicine
4613 S ORANGE BLOSSOM TRL
ORLANDO, FL 32839
Orange County (407) 232-9829
SERGIO MIGUEL DELGADO
Family Medicine
4613 S ORANGE BLOSSOM TRL
ORLANDO, FL 32839
Orange County (407) 232-9833
DR. AMARILIS PEREZ I MD
Hospitalist
4613 S ORANGE BLOSSOM TRL
ORLANDO, FL 32839
Orange County (407) 232-9833
RACHITA BANSAL MD
Internal Medicine
4613 S ORANGE BLOSSOM TRL
ORLANDO, FL 32839
Orange County (407) 232-9833
DR. ANDREW MANZATTO SANTOS MD
Internal Medicine
4613 S ORANGE BLOSSOM TRL
ORLANDO, FL 32839
Orange County (407) 232-9833

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 Fagan's NPI number?

The NPI number for Amanda Fagan is 1245617802. It was assigned to this individual provider in the NPPES registry on May 4, 2015. The provider is also known as Amanda Lynne Stuck.

Where is Amanda Fagan located?

Amanda Fagan practices at 4613 S Orange Blossom Trl, Orlando, FL 32839. The listed phone number is (407) 232-9833.

What is Amanda Fagan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Amanda Fagan enrolled in Medicare?

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

Which organizations bill Medicare for Amanda Fagan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Fagan reassigns Medicare benefits to 3 organizations: Dedicated Senior Medical Center Of Florida, LLC (Tampa, FL), Southwest Medical Associates, Inc (Las Vegas, NV) and Optum Medical Group II Rhodes P C (Las Vegas, NV). Each 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 Fagan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Amanda Fagan was last updated on February 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.