AMANDA CAVAZOS (PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1578379848

AMANDA CAVAZOS (PMHNP-BC) is a healthcare provider. based in Mattoon, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP-BC. They hold a License No. 209031211 (IL). The NPI Number for AMANDA CAVAZOS (PMHNP-BC) is 1578379848

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA CAVAZOS (PMHNP-BC)
NPI
1578379848
Phone
(217) 276-6945
Address
3316 CHESTNUT AVE
Enumeration Date
10 December 2024
Last Update Date
10 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2173731700
Graduation Year
2024 (2 years ago)
PAC ID
8426575242
Group Practice PAC ID
7911043740
Professional Enrollment ID
I20250506001111
Address ID
IL618203320CH809XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

11,637 NURSE PRACTITIONER in IL

Provider Addresses for AMANDA CAVAZOS (PMHNP-BC)

  • 3316 CHESTNUT AVE

    MATTOON, IL 619383615

    Phone: (217) 276-6945

    Type: Mailing

  • 809 W CHURCH ST

    CHAMPAIGN, IL 618203320

    Phone: (217) 373-1700

    Type: Location

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: 2025-05-06

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
I20250506001111INurse PractitionerILTBD

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 61938)

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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: 7911043740View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerIL

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Frequently asked questions

How is AMANDA CAVAZOS (PMHNP-BC) identified in CMS data?
CMS-hosted NPPES data lists AMANDA CAVAZOS (PMHNP-BC) with NPI 1578379848.
Does the file indicate AMANDA CAVAZOS (PMHNP-BC) is practicing under active NPI?
Directory data currently reports AMANDA CAVAZOS (PMHNP-BC) as active.
What healthcare role does AMANDA CAVAZOS (PMHNP-BC) hold?
Scheduling teams often label AMANDA CAVAZOS (PMHNP-BC) under Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is AMANDA CAVAZOS (PMHNP-BC) based?
AMANDA CAVAZOS (PMHNP-BC) is tied to Mattoon, Illinois in the data we show; additional addresses may exist on the full record.
Is the information about AMANDA CAVAZOS (PMHNP-BC) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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