Amanda Nicole Peters, PA is a medicare enrolled "Physician Assistant" in Brillion, Wisconsin. She graduated from nursing school in 2020 and has 6 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Bellin Memorial Hospital Inc and her current practice location is
964 W Ryan St, Brillion, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 756-2055.
Amanda Nicole Peters is licensed to practice in Wisconsin (license number 5094) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1063046761.
Provider's Profile
| Full Name | Amanda Nicole Peters |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 6 Years |
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| Location | 964 W Ryan St, Brillion, Wisconsin |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Amanda Nicole Peters graduated from nursing school in 2020
NPI Data:
- NPI Number: 1063046761
- Provider Enumeration Date: 03/03/2020
- Last Update Date: 01/03/2023
Medicare PECOS Information:
- PECOS PAC ID: 1052738556
- Enrollment ID: I20200828002156
Medical Identifiers
Medical identifiers for Amanda Nicole Peters such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1063046761 | NPI | - | NPPES |
| 1172171 | Other | | NATIONAL COMMISSION ON CERTIFIED PHYSICIAN ASSISTANTS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | 5094 (Wisconsin) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Bellin Memorial Hospital Inc | 8820900749 | 685 |
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 Nicole Peters allows following entities to bill medicare on her behalf.
| Entity Name | Bellin Memorial Hospital Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1609838473
PECOS PAC ID: 8820900749
Enrollment ID: O20031121000089 |
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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 Nicole Peters 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 |
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Amanda Nicole Peters, PA
Po Box 22487,
Green Bay, WI 54305-2487
Ph: (920) 445-7210 | Amanda Nicole Peters, PA
964 W Ryan St,
Brillion, WI 54110-1076
Ph: (920) 756-2055 |
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