Individual provider Active NPI

Amy Patricia Reardon, PA-C

  • Physician Assistant
  • Wilmington, NC
National Provider Identifier
1356743140
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001009954 Issued in NC
Practice address
2131 S 17TH St
Wilmington, NC 28401-7407
Phone
(910) 667-2606
NPI assigned
Sep 23, 2014
Last updated
May 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0008477 MD
Physician Assistant 363A00000X PAT 9108152 FL
Physician Assistant 363A00000X 001009954 NC Primary

Addresses

Primary practice location

2131 S 17TH St
Wilmington, NC 28401-7407

Mailing address

PO Box 936857
Atlanta, GA 31193-6857

Other practice location 1

22 S Greene St
Baltimore, MD 21201-1544
Phone (667) 214-1718

Other names 1

  • Ms. Amy Patricia Romito Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, MD2 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
I20200728001349 NC Practitioner - Physician Assistant 0749402337 Reassigns benefits to 2 organizations
I20230504003236 MD Practitioner - Physician Assistant 0749402337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 667-4620

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAT 9108152FLMDPhysician Assistant
C0008477MDMDPhysician Assistant
001009954NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Urgent Care, LLC CurrentSince Dec 27, 2014 Accepting new patients
University of Maryland Surgcial Assoc PA Past Accepting new patients
Bay Area Emergency Physicians Urgent Care LLC Past Accepting new patients

Locations

13670 Walsingham Rd
Largo, FL 33774
Phone (727) 593-9848

4821 US Highway 19
Ste 5
New Port Richey, FL 34652
Phone (727) 851-9650

2331 4th St N
St Petersburg, FL 33704
Phone (727) 593-9848

Interoperability endpoints

  • Direct secure messaging: areardon926649@direct.umm.edu

Organizations & group practices 6

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

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": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1356743140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857",
            "fax_number": "410-706-6976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017407",
            "telephone_number": "910-667-2606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 S Greene St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "667-214-1718",
            "fax_number": "410-328-5147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REARDON",
        "first_name": "AMY",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008477",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT 9108152",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001009954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "ROMITO",
            "middle_name": "PATRICIA",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.