Individual provider Active NPI

Amy J Pantaleo, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Aventura, FL
National Provider Identifier
1053698910
Registry record updated Feb 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71003856A Issued in IN
Practice address
21414 W Dixie Hwy
Aventura, FL 33180-1144
Phone
(786) 626-5555
NPI assigned
Nov 7, 2011
Last updated
Feb 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71003856A IN Primary

Addresses

Primary practice location

21414 W Dixie Hwy
Aventura, FL 33180-1144

Mailing address

1612 Jefferson Ave Apt 401
Miami Beach, FL 33139-7613
Phone (786) 626-7555

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referral@vitas.direct.kno2fy.com VITAS Solutions Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131004000497 FL Practitioner - Nurse Practitioner 9931351798 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71003856AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitas Solutions Inc CurrentSince Oct 26, 2013 Accepting new patients

Locations

5430 NW 33rd Ave
Ste 106
Ft Lauderdale, FL 33309
Phone (877) 884-8277

123 SE 3rd Ave
Miami, FL 33131
Phone (305) 814-8637

3720 Executive Way
Miramar, FL 33025

Interoperability endpoints

  • Direct secure messaging: referral@vitas.direct.kno2fy.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707004800000",
    "number": "1053698910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 JEFFERSON AVE APT 401",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331397613",
            "telephone_number": "786-626-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21414 W DIXIE HWY",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801144",
            "telephone_number": "786-626-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTALEO",
        "first_name": "AMY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-07",
        "last_updated": "2024-02-04",
        "certification_date": "2024-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003856A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referral@vitas.direct.kno2fy.com",
            "affiliation": "Y",
            "affiliationName": "VITAS Solutions Inc",
            "address_1": "3720 Executive Way",
            "city": "Miramar",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330253946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.