Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Amanda Mackillop, NP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1770128753

Amanda Mackillop, NP is a Nurse Practitioner in Southold, New York. Qualified in 2021, 5 years ago. Practices with Meeting House Lane Medical Practice PC, a 123-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2019
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Practice location Address checks out

54655 Main Rd
Southold, NY 11971-4769
Phone: (631) 301-2271
Fax: (631) 212-0482
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 403484 (NY)
Registered Nurse Taxonomy 163W00000X · Licence 780342 (NY)

Record details

NPI number1770128753
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorYes
NPI enumeratedNovember 13, 2019
Last updated in NPPESDecember 17, 2025
Certification dateDecember 17, 2025
Mailing address54655 Main Rd, Southold, NY 11971-4769

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Meeting House Lane Medical Practice Pc — 123 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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