CMS-1500 Box 24J / 33a • NPI
1558027052
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LG0600X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Gerontology
Box 32 Service Location & ZIP+4
405 S HIGHWAY 44 76, CALEDONIA, MN, 55921-1861
✓ 9-Digit EDI 837 ZIP+4 (55921-1861)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1558027052 (AMANDA MAE HARTZELL MIDDENDORF, APNP) 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
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1558027052)
Medicare Beneficiaries
102
Total Billed Services
1,060
Distinct CPT/HCPCS Codes
21
Medicare Allowed Total
$55,552.54
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 39 |
99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | 24 |
99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | 20 |
99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | 124 |
99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 192 |
99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 19 |
99441 | Telephone medical discussion with physician, 5-10 minutes | 165 |
99442 | Telephone medical discussion with physician, 11-20 minutes | 78 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Amlodipine Besylate Amlodipine Besylate | 11 | <11 |
| Baclofen Baclofen | 17 | <11 |
| Buspirone Hcl Buspirone Hcl | 27 | 14 |
| Furosemide Furosemide | 15 | <11 |
| Gabapentin Gabapentin | 36 | 12 |
| Hydrocodone-Acetaminophen Hydrocodone/Acetaminophen | 14 | <11 |
| Lantus Solostar Insulin Glargine,hum.Rec.Anlog | 18 | <11 |
| Lisinopril Lisinopril | 12 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1558027052 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | AMANDA MAE HARTZELL MIDDENDORF, APNP |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Gerontology NUCC Code: 363LG0600X (Nurse Practitioner, Gerontology) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 405 S HIGHWAY 44 76, CALEDONIA, MN, 55921-1861 |
| Practice Telephone / Fax | Tel: (608) 668-9118 | Fax: (608) 305-8746 |
| Administrative Mailing Address | 405 S HIGHWAY 44 76, CALEDONIA, MN, 55921-1861 |
| Enumeration & Last Sync | Enumerated: 2021-11-10 | CMS Record Updated: 2026-02-02 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LG0600X)
What Does Taxonomy Code 363LG0600X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LG0600X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Gerontology"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (AMANDA MAE HARTZELL MIDDENDORF, APNP)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363LA2200X — Nurse Practitioner, Adult HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health | State: WI | License: 11435 | Primary: Secondary |
363LG0600X — Nurse Practitioner, GerontologyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Gerontology | State: WI | License: 11435 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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