Individual provider Active NPI

Emily Amedeo

  • Family Nurse Practitioner
  • Slidell, LA
National Provider Identifier
1063387264
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
244088 Issued in LA
Practice address
198 Moonraker Dr
Slidell, LA 70458-5521
Phone
(985) 664-6739
NPI assigned
Oct 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN107092 LA
Family Nurse Practitioner 363LF0000X 244088 LA Primary

Addresses

Primary practice location

198 Moonraker Dr
Slidell, LA 70458-5521

Mailing address

198 Moonraker Dr
Slidell, LA 70458-5521
Phone (985) 664-6739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20251122000058 LA Practitioner - Nurse Practitioner 2668609561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5410 Maryland Way
Suite 400
Brentwood, TN 37027-8087

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN107092LAMDRegistered Nurse
244088LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monogram Health Professional Services PC Family CurrentSince Nov 10, 2025 Accepting new patients
Monogram Health Professional Services PC Family CurrentSince Nov 10, 2025 Accepting new patients

Locations

2900 Westfork Dr
Ste 401
Baton Rouge, LA 70827
Phone (225) 953-0895

Interoperability endpoints

  • Direct secure messaging: emily.amedeo.1@22854.direct.athenahealth.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1759795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1063387264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 MOONRAKER DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704585521",
            "telephone_number": "985-664-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 MOONRAKER DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704585521",
            "telephone_number": "985-664-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMEDEO",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-07",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN107092",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "244088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.