Individual provider Active NPI

Amanda R Specchio, FNP

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1215598487
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01113000 Issued in NJ
Practice address
256 Mason Ave
Staten Island, NY 10305-3408
Phone
(718) 226-6400
NPI assigned
Jun 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 344020 NY
Registered Nurse 163W00000X 657473-1 NY
Family Nurse Practitioner 363LF0000X 26NJ01113000 NJ Primary

Addresses

Primary practice location

256 Mason Ave
Staten Island, NY 10305-3408

Mailing address

256 Mason Ave # C
Staten Island, NY 10305-3408
Phone (718) 226-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200501002382 NY Practitioner - Nurse Practitioner 2860823069 Reassigns benefits to 2 organizations
I20221021001671 NJ Practitioner - Nurse Practitioner 2860823069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rutgers Health-RWJ Scleroderma ProgramGroup PAC ID 5193764991, 390 clinicians

Practice addresses (Care Compare)

195 Little Albany St
New Brunswick, NJ 08901-1914
Phone (732) 235-2465

Hospital & facility affiliations

  • Robert Wood Johnson University Hospital Hospital, New Brunswick, NJ, CCN 310038

Merit-based Incentive Payment System (MIPS)

Final score
88.4 of 100Reported as group
Quality
70.64
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
657473-1NYMDRegistered Nurse
344020NYMDGeneral Practice Physician
26NJ01113000NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Sep 12, 2022 Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
North Shore Health System Medical Faculty Group Practice Inc CurrentSince Aug 15, 2021 Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Sep 12, 2022 Accepting new patients
Rutgers Health-RWJ Primary Medicine Group Current Accepting new patients
North Shore-Lij Medical PC CurrentSince Mar 1, 2020 Accepting new patients
Rutgers Health-RWJ Scleroderma Program Past Accepting new patients

Locations

195 Little Albany St
New Brunswick, NJ 08901
Phone (732) 235-2465

125 Paterson St
Ste 5100
New Brunswick, NJ 08901
Phone (732) 235-7060

125 Paterson St
Ste 6100
New Brunswick, NJ 08901
Phone (732) 235-6561

1 Robert Wood Johnson Pl
Ste 1B
New Brunswick, NJ 08901

1140 Route 72 W
Stafford Township, NJ 08050
Phone (609) 978-2194

450 Lakeville Rd
North New Hyde Park, NY 11042
Phone (516) 321-3000

300 Community Dr
Plandome, NY 11030

256 Mason Ave
#C
Staten Island, NY 10305
Phone (718) 226-1251

256 Mason Ave
Staten Island, NY 10305
Phone (718) 226-9508

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: amandamolloy@nslijmedgr.allscriptsdirect.net

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1215598487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 MASON AVE # C",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 MASON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPECCHIO",
        "first_name": "AMANDA",
        "middle_name": "R",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344020",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "657473-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01113000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.