AMANDA ROSE LANDOLT FNP-C
NPI 1649007469
Nurse Practitioner in Green Bay, WI
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 maintains a secondary practice location in Green Bay.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
3Medicare enrollment records show Amanda Landolt reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Green Bay, WI 54304
- Reassigned Medicare billing, Wisconsin enrollment
- 190 clinicians in this Medicare group
Green Bay, WI 54304
- Reassigned Medicare billing, Wisconsin enrollment
- 742 clinicians in this Medicare group
Sheboygan, WI 53081
- Reassigned Medicare billing, Wisconsin enrollment
- 673 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, WIPhysician 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.
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.
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 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.
Where is Amanda Landolt located?
Amanda Landolt practices at 2502 S Ashland Ave, Green Bay, WI 54304. The listed phone number is (920) 496-4700.
What is Amanda Landolt's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Amanda Landolt enrolled in Medicare?
Yes. Amanda Landolt is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Amanda Landolt's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Landolt reassigns Medicare benefits to 3 organizations: Prevea Clinic, Inc. (Green Bay, WI), St Vincent Hospital-Hospital Sisters-Third Order Of St Francis (Green Bay, WI) and St. Nicholas Hospital-Sisters Of The Third Order Of St Francis (Sheboygan, WI). 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 Landolt's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Amanda Landolt affiliated with any hospitals?
According to CMS data, Amanda Landolt is affiliated with St Vincent Hospital.
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 22 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.
# Amanda Rose Landolt, FNP-C · NPI 1649007469
Nurse Practitioner physician in Green Bay, Wisconsin. Individual provider, active in the CMS NPPES registry since September 16, 2024.
## Identity
- **NPI:** 1649007469 (Entity type: Individual)
- **Enumerated:** September 16, 2024
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 15732-33 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 2502 S ASHLAND AVE, Green Bay, WI 54304-5252
- **Phone:** (920) 496-4700
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Prevea Clinic, Inc. (NPI 1306869276, Green Bay, WI); St Vincent Hospital-Hospital Sisters-Third Order Of St Francis (NPI 1285613638, Green Bay, WI); St. Nicholas Hospital-Sisters Of The Third Order Of St Francis (NPI 1275799413, Sheboygan, WI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** December 20, 2024
- **Other identifiers:** Medicaid 100292996 (WI)
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Source: [NPI Profile](https://npiprofile.com/npi/1649007469) · Data from the CMS NPPES public registry.