Individual provider Active NPI

Amy Brenner Corso, NP

  • Pediatric Nurse Practitioner
  • Washington, DC
National Provider Identifier
1215195458
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN962566 Issued in DC
Practice address
4200 Wisconsin Ave NW Ste 4
Washington, DC 20016-2143
Phone
(202) 243-3400
NPI assigned
May 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN962566 DC Primary

Addresses

Primary practice location

4200 Wisconsin Ave NW Ste 4
Washington, DC 20016-2143

Mailing address

4200 Wisconsin Ave NW Ste 4
Washington, DC 20016-2143
Phone (202) 243-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20081216000541 DC Practitioner - Nurse Practitioner 6103988746 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN962566DCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MGMC, LLC Current Accepting new patients
Medstar Medical Group II LLC CurrentSince Oct 16, 2018 Accepting new patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince Oct 16, 2018 Accepting new patients
Medstar Georgetown Medical Center, Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4200 Wisconsin Ave NW
Washington, DC 20016
Phone (202) 243-3400

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

4200 Wisconsin Ave NW
Ste 4
Washington, DC 20016
Phone (202) 243-3400

Organizations & group practices 7

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": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1215195458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 WISCONSIN AVE NW STE 4",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162143",
            "telephone_number": "202-243-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 WISCONSIN AVE NW STE 4",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162143",
            "telephone_number": "202-243-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORSO",
        "first_name": "AMY",
        "middle_name": "BRENNER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "DC",
            "license": "RN962566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.