Amanda Lynn Stathos, MS, RD, LD is a medicare enrolled "Dietitian, Registered" provider in Lorton, Virginia. Her current practice location is
9031 Endicott Pl, Lorton, Virginia. You can reach out to her office (for appointments etc.) via phone at
(815) 321-1555.
Amanda Lynn Stathos is licensed to practice in District Of Columbia (license number DI100001076) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1144869678.
Healthcare Provider's Profile
Full Name | Amanda Lynn Stathos |
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Gender | Female |
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Speciality | Dietitian, Registered |
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Location | 9031 Endicott Pl, Lorton, Virginia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1144869678
- Provider Enumeration Date: 01/01/2020
- Last Update Date: 09/15/2022
Medicare PECOS Information:
- PECOS PAC ID: 6901277003
- Enrollment ID: I20230128000161
Medical Identifiers
Medical identifiers for Amanda Lynn Stathos such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1144869678 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | DI100001076 (District Of Columbia) | Primary |
133V00000X | Dietitian, Registered | DX5408 (Maryland) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amanda Lynn Stathos allows following entities to bill medicare on her behalf.
Provider Name | Amanda Lynn Nutrition Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1407578511 PECOS PAC ID: 5092186197 Enrollment ID: O20230128000125 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Lynn Stathos is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Amanda Lynn Stathos, MS, RD, LD 9031 Endicott Pl, Lorton, VA 22079-4541 Ph: (815) 321-1555 | Amanda Lynn Stathos, MS, RD, LD 9031 Endicott Pl, Lorton, VA 22079-4541 Ph: (815) 321-1555 |
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