AMANDA SUSAN BOO P.A.
NPI 1558813907
Physician Assistant - Medical in Riverside, IL
About Amanda Susan Boo P.a. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AMANDA SUSAN BOO P.A. (NPI 1558813907) is an individual medical provider in Riverside, Illinois, licensed in Illinois (085006069) and active in the NPI registry since November 2016. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Amanda Susan Boo P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Boo's NPI number?
The NPI number for Amanda Boo is 1558813907. It was assigned to this individual provider in the NPPES registry on November 2, 2016.
Where is Amanda Boo located?
Amanda Boo practices at 2910 Harlem Ave, Riverside, IL 60546. The listed phone number is (708) 447-4267.
What is Amanda Boo's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Amanda Boo enrolled in Medicare?
Yes. Amanda Boo is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Amanda Boo was last updated on November 2, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Amanda Susan Boo, P.A. · NPI 1558813907
Medical physician in Riverside, Illinois. Individual provider, active in the CMS NPPES registry since November 2, 2016.
## Identity
- **NPI:** 1558813907 (Entity type: Individual)
- **Enumerated:** November 2, 2016
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** 085006069 (Illinois)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2910 HARLEM AVE, Riverside, IL 60546-1785
- **Phone:** (708) 447-4267
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** November 2, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1558813907) · Data from the CMS NPPES public registry.