MRS. AMANDA SUE AL-KHUDAIRI MSN, RNC, APRN
NPI 1861613242
Nurse Practitioner - Women's Health in Salt Lake City, UT
About Mrs. Amanda Sue Al-khudairi Msn, Rnc, Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. AMANDA SUE AL-KHUDAIRI MSN, RNC, APRN (NPI 1861613242) is an individual women's health provider in Salt Lake City, Utah, licensed in Utah (372242-4405) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Amanda Sue Al-khudairi Msn, Rnc, Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Amanda Al-khudairi reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Taylorsville, UT 84129
- Reassigned Medicare billing, Utah enrollment
- 295 clinicians in this Medicare group
Salt Lake City, UT 84132
- Reassigned Medicare billing, Utah enrollment
- 2,620 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 84119 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 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WEST VALLEY CITY, UT 84119
WEST VALLEY CITY, UT 84119
WEST VALLEY CITY, UT 84119
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 Al-khudairi's NPI number?
The NPI number for Amanda Al-khudairi is 1861613242. It was assigned to this individual provider in the NPPES registry on May 1, 2007.
Where is Amanda Al-khudairi located?
Amanda Al-khudairi practices at 1906 W 3600 S, Salt Lake City, UT 84119. The listed phone number is (801) 973-9675.
What is Amanda Al-khudairi's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.
Is Amanda Al-khudairi enrolled in Medicare?
Yes. Amanda Al-khudairi is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Amanda Al-khudairi's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Al-khudairi reassigns Medicare benefits to 2 organizations: University Of Utah Community Physicians Group (Taylorsville, UT) and University Of Utah Adult Services (Salt Lake City, UT). 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 Al-khudairi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Amanda Al-khudairi accept?
Health plans from BridgeSpan Health Company, Molina Healthcare and Regence BlueCross BlueShield of Utah list Amanda Al-khudairi 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 Al-khudairi was last updated on October 16, 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.
# Mrs. Amanda Sue Al-Khudairi, MSN, RNC, APRN · NPI 1861613242
Women's Health physician in Salt Lake City, Utah. Individual provider, active in the CMS NPPES registry since May 1, 2007.
## Identity
- **NPI:** 1861613242 (Entity type: Individual)
- **Enumerated:** May 1, 2007
- **Primary specialty:** Nurse Practitioner - Women's Health · taxonomy 363LW0102X
- **State license:** 372242-4405 (Utah)
- **Sole proprietor:** No
## Practice location
- **Address:** 1906 W 3600 S, Salt Lake City, UT 84119-4715
- **Phone:** (801) 973-9675
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): University Of Utah Community Physicians Group (NPI 1932503646, Taylorsville, UT); University Of Utah Adult Services (NPI 1578967345, Salt Lake City, UT) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 16, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1861613242) · Data from the CMS NPPES public registry.