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Export Provider Record NPI 1174901953
Amanda Unalivia BurackerPA-C
Active
NPI Number1174901953
NPI TypeNPI-1 Individual
SpecialtyPhysician Assistant
Provider Details
NPI1174901953
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2015-05-12
Last Updated2025-01-15
Mailing Address801 York St
Manitowoc, WI 54220-4630
United States
Phone: (920) 663-9008 | Fax: (920) 684-1439
📍 View Map
Primary Practice Address3025 Hamaker Ct Ste 340
Fairfax, VA 22031-2237
United States
Phone: (703) 849-8036 | Fax: (703) 204-3448
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No207N00000X – DermatologyNMPA2015-0018
Yes363A00000X – Physician AssistantVA0110005079
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About NPI 1174901953

Amanda Unalivia Buracker PA-C is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1174901953. The primary specialty listed is Physician Assistant. The provider is located in Fairfax, VA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2015-05-12. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1174901953?

NPI 1174901953 belongs to Amanda Unalivia Buracker PA-C, a Physician Assistant in Fairfax, VA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1174901953 active?

The current status of NPI 1174901953 in the NPPES registry is Active. The record was last updated on 2025-01-15.

What specialty is NPI 1174901953?

NPI 1174901953 is classified under the taxonomy Physician Assistant. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1174901953?

You can verify NPI 1174901953 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1174901953?

The primary practice address on file for NPI 1174901953 is 3025 Hamaker Ct Ste 340, Fairfax, VA 22031-2237. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1174901953 issued?

NPI 1174901953 was first issued (enumerated) on 2015-05-12. The NPPES record was last updated on 2025-01-15.

Practice Location Map

Amanda Unalivia Buracker is located at 3025 Hamaker Ct Ste 340, Fairfax, VA. Use the map below to find directions or verify the practice location.

📍 3025 Hamaker Ct Ste 340, Fairfax, VA 22031-2237  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Amanda Unalivia Buracker. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1174901953. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
DermatologyPA2015-0018NM
Physician Assistant0110005079VA
Data Verified from CMS NPPES Last synced: 2026-07-10 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162