AMANDA PIMENTEL (PA-C) – Physician Assistant, NPI 1265812739
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for AMANDA PIMENTEL (PA-C)
12234 SHADOW CREEK PKWY STE 4104
PEARLAND, TX 775847333
Phone:
Type: Mailing
1875 W Dempster St Ste 470
Park Ridge, IL 600681129
Phone: (847) 795-3100
Fax: (847) 723-5882
Type: Location
PO BOX 781076
DETROIT, MI 482781076
Phone: (317) 528-4800
Fax: (317) 865-1479
Type: Mailing
24 JOLIET ST
DYER, IN 463111705
Phone: (219) 322-5747
Fax: (219) 864-2282
Type: Location
29373 NETWORK PL
CHICAGO, IL 606733200
Phone:
Type: Mailing
1875 W DEMPSTER ST STE 470
PARK RIDGE, IL 600681129
Phone: (847) 795-3100
Fax: (847) 723-5882
Type: Location
10920 ARKANSAS PL
CROWN POINT, IN 463070195
Phone: (219) 730-4903
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $26.
Total Amount is formed as General ($26) + Research ($0) + Ownership ($0) = $26.
Last reported payment date: 2023-08-25 • Largest payer in this snapshot: ABBVIE INC. ($26).
Total Amount
$26
General + Research + Ownership
Payments
1
Total payment records
General Amount
$26
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $26 |
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: 2019-08-16
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180328001102 | I | Physician Assistant | IN | TBD |
| I20190816001331 | I | Physician Assistant | IL | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 55 | 20 | $0 |
Insurance plans in this area (ZIP 77584)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| - | IN | |
| - | IN | |
| - | MI | |
| - | IN | |
| - | IN | |
| Family Practice | IN | |
| - | MI | |
| Internal Medicine | IN | |
| Internal Medicine, Emergency Medicine | MI |
Reviews
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