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AMANDA WORTMAN FNP
NPI 1972139095
Nurse Practitioner - Family in Eagle Butte, SD

Active since March 20, 2020PECOS Enrolled
24276 166TH ST, AIRPORT RD, EAGLE BUTTE, SD 57625(605) 964-7724 Get Directions Write a Review

NPPES record last updated: June 29, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 29, 2020, Mar 20, 2020 (2 updates tracked since 2020).

About Amanda Wortman Fnp NPPES

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

AMANDA WORTMAN FNP (NPI 1972139095) is an individual family provider in Eagle Butte, South Dakota, licensed in South Dakota (CP001742) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972139095
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameAMANDA WORTMANCredential: FNP
Location Address24276 166TH ST, AIRPORT RDEagle Butte, SD 57625-1012
Mailing Address101 Mercury StPierre, SD 57501-5672 · (605) 939-9577
Phone(605) 964-7724
Sole ProprietorNo
Enumeration DateMarch 20, 2020
Last NPPES UpdateJune 29, 20202 updates tracked since enumeration
NPPES CertifiedJune 29, 2020
✔ NPI 1972139095 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 SD · CP001742
24276 166TH ST, AIRPORT RD, Eagle Butte, SD 57625
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Wortman Fnp 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57625 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
$85.21 typical visit price
range $55.52 – $167.23
Typical copayment $21.30 (range $13.88 – $41.80)
Most-billed visit code 99203
Established Patient
$97.88 typical visit price
range $18.08 – $137.08
Typical copayment $24.47 (range $4.52 – $34.27)
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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier19 claims19 services$38.16 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Wortman's NPI number?

The NPI number for Amanda Wortman is 1972139095. It was assigned to this individual provider in the NPPES registry on March 20, 2020.

Where is Amanda Wortman located?

Amanda Wortman practices at 24276 166th St, Airport Rd, Eagle Butte, SD 57625. The listed phone number is (605) 964-7724.

What is Amanda Wortman's specialty?

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

Is Amanda Wortman enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Amanda Wortman was last updated on June 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.