Amanda Diane Griffin, MD is a medicare enrolled "Pediatrics" physician in Pryor, Oklahoma. Her current practice location is
1301 Ne 13th St, Suite 100, Pryor, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(918) 824-6479.
Amanda Diane Griffin is licensed to practice in Oklahoma (license number 45631) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1124280680.
Physician's Profile
Full Name | Amanda Diane Griffin |
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Gender | Female |
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Speciality | Pediatrics |
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Location | 1301 Ne 13th St, Pryor, Oklahoma |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1124280680
- Provider Enumeration Date: 06/26/2008
- Last Update Date: 08/05/2025
Medicare PECOS Information:
- PECOS PAC ID: 3072782069
- Enrollment ID: I20110809000105
Medical Identifiers
Medical identifiers for Amanda Diane Griffin such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1124280680 | NPI | - | NPPES |
280022902 | Medicaid | TX | |
280022904 | Medicaid | TX | |
280022903 | Medicaid | TX | |
200339720 A | Medicaid | OK | |
280022901 | Medicaid | TX | |
78286051 | Medicaid | NM | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 45631 (Oklahoma) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amanda Diane Griffin allows following entities to bill medicare on her behalf.
Entity Name | Texas Tech University Health Sciences Center Amarillo |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1013942150 PECOS PAC ID: 9234037847 Enrollment ID: O20031220000051 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Diane Griffin is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Amanda Diane Griffin, MD 110 W 7th St Ste 2520, Tulsa, OK 74119-1104 Ph: (918) 579-3826 | Amanda Diane Griffin, MD 1301 Ne 13th St, Suite 100, Pryor, OK 74361 Ph: (918) 824-6479 |
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