AMANDA JENE WIRTH APRN
NPI 1619370053
Nurse Practitioner - Women's Health in Lakeland, FL

Q: What is Amanda Wirth's NPI number?

The NPI number for Amanda Wirth is 1619370053. It was assigned to this individual provider in the NPPES registry on September 30, 2014.

Q: What is Amanda Wirth's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Wirth was last updated on January 20, 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.

Active since September 30, 2014PECOS Enrolled

215 IMPERIAL BLVD STE B2, LAKELAND, FL 33803(813) 684-2229(813) 413-8507 Get Directions Write a Review

NPPES record last updated: January 20, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 20, 2021, Sep 24, 2020, Apr 5, 2019 and 2 more (5 updates tracked since 2017).

On this page

About Amanda Jene Wirth Aprn NPPES

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

AMANDA JENE WIRTH APRN (NPI 1619370053) is an individual women's health provider in Lakeland, Florida, licensed in Florida (APRN9482070) and active in the NPI registry since September 2014. She is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1619370053

Entity TypeIndividualFemale

Primary Taxonomy363LW0102X

Provider Legal NameAMANDA JENE WIRTHCredential: APRN

Location Address215 IMPERIAL BLVD STE B2Lakeland, FL 33803-4689

Mailing Address215 Imperial Blvd Ste B2Lakeland, FL 33803-4689 · (813) 684-2229 · Fax (813) 413-8507

Phone(813) 684-2229

Fax(813) 413-8507

Sole ProprietorNo

Enumeration DateSeptember 30, 2014

Last NPPES UpdateJanuary 20, 20215 updates tracked since enumeration

NPPES CertifiedJanuary 20, 2021

✔ NPI 1619370053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LW0102X

Licenses✔ Licensed in FL · APRN9482070✔ Licensed in OH · 16289

215 IMPERIAL BLVD STE B2, Lakeland, FL 33803

Open in Google Maps ↗

Secondary Practice Locations 3

Location 11410 W Broadway StOviedo, FL 32765-6456 · Phone (407) 366-9195 · Fax (407) 898-9944

Location 21515 Park Center Dr Ste 2AOrlando, FL 32835-5794 · Phone (407) 296-8044 · Fax (407) 898-9944

Location 3785 Primera BlvdLake Mary, FL 32746 · Phone (407) 834-8111

Other Identifiers 2

Medicaid024693700FL

Medicaid0111806OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, CareSource (Common Ground Healthcare).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 Jene Wirth Aprn 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

Medicare enrollment records show Amanda Wirth reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Florida Hospital Physician Group Inc

29 mi

Family Medicine

3000 MEDICAL PARK DR, STE 320
Tampa, FL 33613

Reassigned Medicare billing, Florida enrollment
1,719 clinicians in this Medicare group

NPI 1174955256 (813) 336-5766

Signify Health, LLC

950 mi

General Practice

4055 VALLEY VIEW LN STE 700
Dallas, TX 75244

Reassigned Medicare billing, Ohio enrollment
672 clinicians in this Medicare group

NPI 1689158487 (469) 466-7007

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 33803 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 3

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

EXODUS WOMEN'S CENTER, INC.

Obstetrics & Gynecology

215 IMPERIAL BLVD STE B2
LAKELAND, FL 33803

Polk County (813) 684-2229

PAMELA S HODGES M.D.

Obstetrics & Gynecology

215 IMPERIAL BLVD STE B2
LAKELAND, FL 33803

Polk County (813) 684-2229

LAKELAND'S CHILDREN THERAPY CENTER, LLC

Physical Therapist (Pediatrics)

215 IMPERIAL BLVD STE B2
LAKELAND, FL 33803

Polk County (786) 602-0904

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 Wirth's NPI number?

The NPI number for Amanda Wirth is 1619370053. It was assigned to this individual provider in the NPPES registry on September 30, 2014.

Where is Amanda Wirth located?

Amanda Wirth practices at 215 Imperial Blvd Ste B2, Lakeland, FL 33803. The listed phone number is (813) 684-2229.

What is Amanda Wirth's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

Is Amanda Wirth enrolled in Medicare?

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

Which organizations bill Medicare for Amanda Wirth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Wirth reassigns Medicare benefits to 2 organizations: Florida Hospital Physician Group Inc (Tampa, FL) and Signify Health, LLC (Dallas, TX). 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 Wirth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Amanda Wirth accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource and CareSource (Common Ground Healthcare) list Amanda Wirth 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 Wirth was last updated on January 20, 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.