AMANDA ROSE LANDOLT FNP-C
NPI 1649007469
Nurse Practitioner in Green Bay, WI

Q: What is Amanda Landolt's NPI number?

The NPI number for Amanda Landolt is 1649007469. It was assigned to this individual provider in the NPPES registry on September 16, 2024.

Q: What is Amanda Landolt's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Landolt was last updated on December 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.

Active since September 16, 2024PECOS EnrolledAccepts Medicare Assignment

2502 S ASHLAND AVE, GREEN BAY, WI 54304(920) 496-4700 Get Directions Write a Review

NPPES record last updated: December 20, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 20, 2024, Sep 16, 2024 (2 updates tracked since 2024).

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About Amanda Rose Landolt Fnp-c NPPES

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

AMANDA ROSE LANDOLT FNP-C (NPI 1649007469) is an individual nurse practitioner in Green Bay, Wisconsin, licensed in Wisconsin (15732-33) and active in the NPI registry since September 2024. She is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1649007469

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameAMANDA ROSE LANDOLTCredential: FNP-C

Location Address2502 S ASHLAND AVEGreen Bay, WI 54304-5252

Mailing AddressPo Box 19070Green Bay, WI 54307-9070 · (920) 496-4700

Phone(920) 496-4700

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateSeptember 16, 2024

Last NPPES UpdateDecember 20, 20242 updates tracked since enumeration

NPPES CertifiedDecember 20, 2024

✔ NPI 1649007469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in WI · 15732-33

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

2502 S ASHLAND AVE, Green Bay, WI 54304

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Other Identifiers 1

Medicaid100292996WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Amanda Rose Landolt Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42743320

PECOS Enrollment IDI20241024002743

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number520075

Location835 S Van Buren StGreen Bay, WI 54301 · Brown County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54304 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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 20

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

CANDICE CRABB

Nurse Practitioner (Family)