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AMANDA LEE MCDERMOTT
NPI 1912661505
Nurse Practitioner - Family in Syracuse, NY

Active since October 28, 2021PECOS Enrolled
104 UNION AVE STE 904, SYRACUSE, NY 13203(315) 703-5108 Get Directions Write a Review

NPPES record last updated: October 28, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Amanda Lee Mcdermott NPPES

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

AMANDA LEE MCDERMOTT (NPI 1912661505) is an individual family provider in Syracuse, New York, licensed in New York (347686) and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912661505
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameAMANDA LEE MCDERMOTT
Location Address104 UNION AVE STE 904Syracuse, NY 13203-1845
Mailing Address105 Scott LnLiverpool, NY 13088-5433 · (315) 663-5145
Phone(315) 703-5108
Sole ProprietorNo
Enumeration DateOctober 28, 2021
NPPES CertifiedOctober 28, 2021
✔ NPI 1912661505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 347686
104 UNION AVE STE 904, Syracuse, NY 13203
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Lee Mcdermott 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 Reassignment

Medicare enrollment records show Amanda Mcdermott reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St Josephs Medical PC
4.5 mi
Family Medicine
5100 W TAFT RD
Liverpool, NY 13088
  • Reassigned Medicare billing, New York enrollment
  • 625 clinicians in this Medicare group
NPI 1942501747 (315) 452-2828

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 13203 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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

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

JESSICA DEORDIO FNP
Nurse Practitioner (Family)
104 UNION AVE STE 904
SYRACUSE, NY 13203
Onondaga County (315) 430-5198

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 Mcdermott's NPI number?

The NPI number for Amanda Mcdermott is 1912661505. It was assigned to this individual provider in the NPPES registry on October 28, 2021.

Where is Amanda Mcdermott located?

Amanda Mcdermott practices at 104 Union Ave Ste 904, Syracuse, NY 13203. The listed phone number is (315) 703-5108.

What is Amanda Mcdermott's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Amanda Mcdermott enrolled in Medicare?

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

Which organization bills Medicare for Amanda Mcdermott's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Mcdermott reassigns Medicare benefits to St Josephs Medical PC (Liverpool, NY). The 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 Mcdermott's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Amanda Mcdermott was last updated on October 28, 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.