NELLY Y AMADOR, M.D., PMD — NPI 1336119064 (Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) in BOSCOBEL, WI)

CMS-1500 Box 24J / 33a • NPI

1336119064

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

207P00000X (CMS 93)

Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)

Box 32 Service Location & ZIP+4

205 PARKER ST, BOSCOBEL, WI, 53805-1642

✓ 9-Digit EDI 837 ZIP+4 (53805-1642)

Practice Phone & Referral Fax

(608) 375-4112

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1336119064 (NELLY Y AMADOR, M.D., PMD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1336119064` (NPI-1 Individual Practitioner)
Provider / Legal Name	NELLY Y AMADOR, M.D., PMD
Plain-English Specialty	Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) NUCC Code: `207P00000X` (Emergency Medicine)
Certifying / Licensing Body	American Board of Emergency Medicine (ABEM)
Practice Location Address	205 PARKER ST, BOSCOBEL, WI, 53805-1642
Practice Telephone / Fax	Tel: (608) 375-4112
Administrative Mailing Address	2400 N ROCKTON AVE, ROCKFORD, IL, 61103-3655
Enumeration & Last Sync	Enumerated: 2006-01-25 \| CMS Record Updated: 2026-03-31

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

205 PARKER ST, BOSCOBEL, WI, 53805-1642

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Plain-English Taxonomy & CMS Crosswalk (207P00000X)

What Does Taxonomy Code 207P00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207P00000X translates to:
"Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 93 (Physician/Emergency Medicine)
Certifying / Accrediting Authority: American Board of Emergency Medicine (ABEM)
Clinical Scope: Immediate life-or-limb emergencies, severe chest pain, stroke symptoms, deep contaminated wounds needing tetanus prophylaxis, or severe dehydration.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (NELLY Y AMADOR, M.D., PMD)

Typical CPT / Diagnostic Procedures:

Level 4 & Level 5 Emergency Department Resuscitation (CPT 99284–99285)
Point-of-Care Emergency Ultrasound (eFAST), Intubation & Central Line Placement
Acute Laceration Repair, Tetanus Prophylaxis & Fracture Splinting

Common Therapeutic Classes:

Epinephrine Auto-Injectors / IV Infusions, Atropine & Amiodarone
Tetanus Toxoid / Tdap & Tetanus Immunoglobulin (TIG)
Empiric Sepsis Antibiotics, Parenteral Ketorolac & Ondansetron

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207P00000X` — Emergency Medicine Plain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)	State: IL \| License: `036136816` \| Primary: Secondary
`207P00000X` — Emergency Medicine Plain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)	State: WI \| License: `66004` \| Primary: Yes (Primary)
`207T00000X` — Neurological Surgery Plain English: Board-Certified Neurosurgeon (Brain, Cranial & Spine Surgeon)	State: MN \| License: `48093` \| Primary: Secondary

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NELLY Y AMADOR, M.D., PMD (NPI #1336119064)