MS. AMANDA JEANNA FATA – Clinical Social Worker, NPI 1164755427

MS. AMANDA JEANNA FATA is a healthcare provider. based in Berkley, Massachusetts. specializing in CLINICAL SOCIAL WORKER. The NPI Number for MS. AMANDA JEANNA FATA is 1164755427

Main info

Female
Sole Proprietor
16 Years Of Experience
Accepts Medicare Assignment
Name
MS. AMANDA JEANNA FATA
NPI
1164755427
Phone
(508) 685-8268
Address
100 BAYVIEW AVE
Enumeration Date
17 September 2009
Last Update Date
12 December 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7742223196
Graduation Year
2010 (16 years ago)
PAC ID
3971829219
Professional Enrollment ID
I20171220001472
Address ID
MA023331186EX36XXXSTXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:16State licenses:0Digital endpointsOther names

4,987 CLINICAL SOCIAL WORKER in CA

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Provider Addresses for MS. AMANDA JEANNA FATA

  • 100 BAYVIEW AVE

    BERKLEY, MA 027792200

    Phone: (508) 685-8268

    Fax: (508) 880-6848

    Type: Mailing

  • 1328, 2nd Street, Santa Monica, Los Angeles County, California, 90401, United States

    SANTA MONICA, CA 904011122

    Phone: (310) 394-6889

    Fax: (310) 394-6883

    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: 2017-12-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20150305000003IClinical Social WorkerCATBD
I20171220001472IClinical Social WorkerMATBD

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 02779)

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Reviews

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Frequently asked questions

Does MS. AMANDA JEANNA FATA share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MS. AMANDA JEANNA FATA uses 1164755427.
Does CMS list MS. AMANDA JEANNA FATA as active?
Yes — MS. AMANDA JEANNA FATA is active in the NPI listing used on this page.
What is MS. AMANDA JEANNA FATA best known for clinically?
Directory data describes MS. AMANDA JEANNA FATA with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What address line appears for MS. AMANDA JEANNA FATA?
MS. AMANDA JEANNA FATA's geographic hint is Berkley, Massachusetts in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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