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Amy M Ambrosier

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as AMY AMBROSIER.

Based on the most recent information from CMS, provider Amy M Ambrosier is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 9:43 AM.

Profile Details

Provider ID
1073898821
Provider Type
Individual
Full Name
Ambrosier, Amy M
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
10/12/2011
Last Updated
9/11/2012

Contact Information

Practice Location

190 E Bannock St, Boise, ID 83712-6241

(208) 381-2222

Unlisted Fax

Mailing Location

190 E Bannock St, Boise, ID 83712

(208) 947-7700

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA930 Idaho

Amy M Ambrosier

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Riggs, Rodney

Smith, Cherish L

Baggs, Jacqueline

Vitto, Anthony David

Porter, Robert William

Derkacs, Derek

Bowman, Dustin K

Davis, Brittney

Joly, Celeste

Murphy, Caroline