Individual provider Active NPI

Amanda Joyce Ponte, PA-C

  • Physician Assistant
  • Vero Beach, FL
National Provider Identifier
1356702831
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3546 Issued in CT
Practice address
1155 35TH LN Ste 201a
Vero Beach, FL 32960-6537
Phone
(772) 562-5661
Fax
(772) 562-5702
NPI assigned
Mar 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3546 CT Primary

Addresses

Primary practice location

1155 35TH LN Ste 201a
Vero Beach, FL 32960-6537

Mailing address

1155 35TH LN Ste 201a
Vero Beach, FL 32960-6537
Phone (772) 562-5661

Other practice location 1

380 SW Prima Vista Blvd
Port Saint Lucie, FL 34983-1984
Phone (772) 785-8989

Other practice location 2

11 South Rd
Suite 250
Farmington, CT 06032
Phone (860) 674-0222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3546CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Pediatrics PastSince Aug 1, 2022 Accepting new patients
Pediatrica Health of Florida, LLC PastSince Aug 1, 2022 Accepting new patients
Children's Health Alliance, LLC Past Accepting new patients
Nemours Children's Health, Palm Bay, Primary Care PastSince Jun 27, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: aponte130479@direct.nemours.org
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1356702831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 35TH LN STE 201A",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606537",
            "telephone_number": "772-562-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 35TH LN STE 201A",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606537",
            "telephone_number": "772-562-5661",
            "fax_number": "772-562-5702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 SW Prima Vista Blvd",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "349831984",
            "country_code": "US",
            "telephone_number": "772-785-8989",
            "fax_number": "772-785-6164",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11 South Rd",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "06032",
            "country_code": "US",
            "telephone_number": "860-674-0222",
            "fax_number": "860-674-0024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONTE",
        "first_name": "AMANDA",
        "middle_name": "JOYCE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-11",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.