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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

AMANDA JEANETTE DEROSA PA-C
NPI 1588909659
Physician Assistant in State College, PA

Active since November 30, 2012
915 BENNER PIKE, STATE COLLEGE, PA 16801(814) 867-7030 Get Directions Write a Review

NPPES record last updated: July 10, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 10, 2026, Aug 6, 2024, Apr 15, 2022 and 1 more (4 updates tracked since 2016).

About Amanda Jeanette Derosa Pa-c NPPES

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

AMANDA JEANETTE DEROSA PA-C (NPI 1588909659) is an individual physician assistant in State College, Pennsylvania, licensed in Pennsylvania (MA055829) and active in the NPI registry since November 2012.

NPPES Registry Identity

NPI1588909659
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameAMANDA JEANETTE DEROSACredential: PA-C
Location Address915 BENNER PIKEState College, PA 16801-7395
Mailing Address915 Benner PikeState College, PA 16801-7395 · (814) 867-7030 · Fax (814) 867-7032
Phone(814) 867-7030
Sole ProprietorNo
Enumeration DateNovember 30, 2012
Last NPPES UpdateJuly 10, 20264 updates tracked since enumeration
NPPES CertifiedJuly 10, 2026
✔ NPI 1588909659 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in PA · MA055829
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License MA055829 (PA)
915 BENNER PIKE, State College, PA 16801
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Other Names 1

Former Name (1)Amanda Jeanette Ecklund Pa-c

Other Providers at the Same Location NPPES 7

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

KEYSTONE SERVICE SYSTEMS, INC
Community/Behavioral Health
915 BENNER PIKE
STATE COLLEGE, PA 16801
Centre County (717) 232-7509
KEYSTONE SERVICE SYSTEMS, INC
Occupational Therapy Assistant
915 BENNER PIKE
STATE COLLEGE, PA 16801
Centre County (717) 232-7509
HEIDI BROOKS PETERS MA, CCC-SLP
Speech-Language Pathologist
915 BENNER PIKE
STATE COLLEGE, PA 16801
Centre County (814) 231-0138
MRS. RENEE G JURY PA-C
Physician Assistant
915 BENNER PIKE
STATE COLLEGE, PA 16801
Centre County (814) 867-7030
MRS. KATHERINE MCCULLOUGH MARION MA, CCC-SLP
Speech-Language Pathologist
915 BENNER PIKE
STATE COLLEGE, PA 16801
Centre County (814) 231-0138
FAMILY RECOVERY, LLC
Clinic/Center (Rehabilitation, Substance Use Disorder)
915 BENNER PIKE
STATE COLLEGE, PA 16801
Centre County (814) 867-7030
KADAT PARTNERS LLC
Home Health
915 BENNER PIKE, SUITE A
STATE COLLEGE, PA 16801
Centre County (814) 861-1600

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 Derosa's NPI number?

The NPI number for Amanda Derosa is 1588909659. It was assigned to this individual provider in the NPPES registry on November 30, 2012. The provider is also known as Amanda Jeanette Ecklund Pa-C.

Where is Amanda Derosa located?

Amanda Derosa practices at 915 Benner Pike, State College, PA 16801. The listed phone number is (814) 867-7030.

What is Amanda Derosa's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Amanda Derosa was last updated on July 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 25 days 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.