1. Home
  2. Directory
  3. New York
  4. Southold
  5. Nurse Practitioner
  6. NPI Profile

AMANDA MACKILLOP NP
NPI 1770128753
Nurse Practitioner - Psychiatric/Mental Health in Southold, NY

Active since November 13, 2019PECOS EnrolledAccepts Medicare Assignment
54655 MAIN RD, SOUTHOLD, NY 11971(631) 301-2271(631) 212-0482 Get Directions Write a Review

NPPES record last updated: December 17, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 17, 2025, May 28, 2021, Nov 13, 2019 (3 updates tracked since 2019).

About Amanda Mackillop Np NPPES

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

AMANDA MACKILLOP NP (NPI 1770128753) is an individual psychiatric/mental health provider in Southold, New York, licensed in New York (403484) and active in the NPI registry since November 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1770128753
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameAMANDA MACKILLOPCredential: NP
Location Address54655 MAIN RDSouthold, NY 11971-4769
Mailing Address54655 Main RdSouthold, NY 11971-4769 · (631) 301-2271 · Fax (631) 212-0482
Phone(631) 301-2271
Fax(631) 212-0482
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateNovember 13, 2019
Last NPPES UpdateDecember 17, 20253 updates tracked since enumeration
NPPES CertifiedDecember 17, 2025
✔ NPI 1770128753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in NY · 403484
Also ListedRegistered NurseTaxonomy 163W00000X · License 780342 (NY)
54655 MAIN RD, Southold, NY 11971
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Mackillop Np 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 ID6709257660
PECOS Enrollment IDI20230201000909
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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
209 services45 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
98 services37 patients
Psychotherapy with evaluation and management visit, 30 minutes 90833
Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
62 services16 patients
Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
23 services23 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11971 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

Frequently Asked Questions

What is Amanda Mackillop's NPI number?

The NPI number assigned to this healthcare provider is 1770128753, enumerated as an "individual" on November 13, 2019.

Where is the provider located?

The provider is located at 54655 MAIN RD SOUTHOLD, NY 11971 and the phone number is (631) 301-2271.

What is the provider's specialty?

Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.