Individual provider Active NPI

Amanda Jin-Corcoran

  • Family Nurse Practitioner
  • Providence, RI
National Provider Identifier
1265125397
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN03682 Issued in RI
Practice address
195 Collyer St Ste 201
Providence, RI 02904-1869
Phone
(401) 272-7799
Fax
(401) 453-9078
NPI assigned
Jun 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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 APRN03682 RI Primary

Addresses

Primary practice location

195 Collyer St Ste 201
Providence, RI 02904-1869

Mailing address

15 La Salle SQ
Providence, RI 02903-1814
Phone (401) 444-6779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20230804001998 RI Practitioner - Nurse Practitioner 4183085228 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
Brown Urology, Inc.Group PAC ID 7810254513, 32 clinicians

Practice addresses (Care Compare)

195 Collyer St
Suite 201
Providence, RI 02904-1869
Phone (401) 272-7799

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN03682RIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brown Urology, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Brown Urology, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Brown Urology, Inc. Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Lifespan Physician Group, Inc. Family CurrentSince Jan 1, 2026 Accepting new patients

Locations

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

195 Collyer St
Ste 201
Providence, RI 02904
Phone (401) 421-0710

2 Dudley St
Ste 175185
Providence, RI 02905
Phone (401) 421-0710

15 La Salle Sq
Providence, RI 02903

593 Eddy St
Providence, RI 02903

195 Collyer St
Ste 104
Providence, RI 02904
Phone (401) 276-2026

110 Elm St
Fl 3
Providence, RI 02903

827 N Main St
Ste 4
Providence, RI 02904
Phone (401) 276-2060

Organizations & group practices 5

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 5

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": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1265125397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LA SALLE SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029031814",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 COLLYER ST STE 201",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041869",
            "telephone_number": "401-272-7799",
            "fax_number": "401-453-9078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIN-CORCORAN",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN03682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.