OrganizationAmanda Matje Pa-C PllcPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address7600 N 15th St, Phoenix, AZ 85020-4327(602) 395-0718PECOS EnrollmentBased on the most recent information from CMS, provider Amanda Matje Pa-C Pllc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1962148791Provider TypeOrganizationFull NameAmanda Matje Pa-C PllcSubpartNoEnumeration Date5/5/2022Last Updated5/5/2022Contact InformationPractice LocationPractice Address7600 N 15th St, Phoenix, AZ 85020-4327Phone(602) 395-0718FaxUnlisted FaxMailing LocationMailing AddressPO Box 39179, Phoenix, AZ 85069-9179Phone(602) 395-0718FaxUnlisted FaxAuthorized OfficialNameKoziol, Vanessa (Credentialing)Phone(480) 376-6456Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerIDPENDDescriptionOtherIssuerPENDArizona