MEDICARE: AMANDA M. CRIM PINHEIRO PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA2023-0313	NM
2	363A00000X	Physician Assistant	2009001274	MO
3	172V00000X	Community Health Worker	G-2081	NM

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	602630075	OTHER	MO	MEDICARE
3	P00689756	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	431560263	OTHER		TRICARE WEST

General Provider Information

NPI Number	:	1477792869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA M. CRIM PINHEIRO PA

Provider Business Mailing Address
First Line	:	4112 MEADOW SAGE PL
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4382
Country	:	US
Telephone Number	:	417-671-2066
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 S MAIN ST STE C
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3797
Country	:	US
Telephone Number	:	575-522-8378
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2009
Last Update Date	:	06/16/2026

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Directions to “ AMANDA M. CRIM PINHEIRO PA” Practice Location

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