AMANDA POLLOCK (PA-C) – Physician Assistant, NPI 1003629874

AMANDA POLLOCK (PA-C) is a healthcare provider. based in Orland park, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. The NPI Number for AMANDA POLLOCK (PA-C) is 1003629874

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA POLLOCK (PA-C)
NPI
1003629874
Phone
Not provided
Address
16001 108TH AVE
Enumeration Date
27 January 2025
Last Update Date
27 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7084600007
Graduation Year
2024 (2 years ago)
PAC ID
6608398508
Group Practice PAC ID
5294276259
Professional Enrollment ID
I20250320001482
Address ID
IL604532539OA4700XSTXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness75
Years active:1State licenses:0Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

Provider Addresses for AMANDA POLLOCK (PA-C)

  • 16001 108TH AVE

    ORLAND PARK, IL 604678788

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250320001482IPhysician AssistantILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60467)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5294276259View full group profile
NameSpecialtyState
O T O L A R Y N G O L O G YIL
O T O L A R Y N G O L O G YIL
Qualified AudiologistIL
O T O L A R Y N G O L O G YIL
Qualified AudiologistWA
Nurse PractitionerIL
Qualified AudiologistIL
Qualified AudiologistIL
Qualified AudiologistIL
O T O L A R Y N G O L O G YIL

Reviews

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Frequently asked questions

How do I look up AMANDA POLLOCK (PA-C) by NPI?
Use NPI 1003629874 when you need to reference AMANDA POLLOCK (PA-C) in forms, claims, or directories.
Is AMANDA POLLOCK (PA-C) currently active in the NPI registry?
CMS-published data lists AMANDA POLLOCK (PA-C) as an active registrant.
What field does AMANDA POLLOCK (PA-C) work in?
You can think of AMANDA POLLOCK (PA-C) as practicing within Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is AMANDA POLLOCK (PA-C)'s primary listing?
We display Orland Park, Illinois because that is what the record indicates for AMANDA POLLOCK (PA-C).
Is AMANDA POLLOCK (PA-C) a real provider?
This page reflects official NPPES data for NPI 1003629874. Always confirm identity and privileges with the practice and licensing boards.

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