Individual provider Active NPI

Amanda Spicochi, APRN

  • Pediatric Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1407401631
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN11001691 Issued in FL
Practice address
601 5TH St S
St Petersburg, FL 33701-4804
Phone
(727) 767-3636
Fax
(727) 767-3638
NPI assigned
Aug 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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 APRN11001691 FL Primary

Addresses

Primary practice location

601 5TH St S
St Petersburg, FL 33701-4804

Mailing address

601 5TH St S
St Petersburg, FL 33701-4804
Phone (727) 767-3636

Other practice location 1

7500 Park Blvd N
Pinellas Park, FL 33781-3714
Phone (727) 544-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220815000674 FL Practitioner - Nurse Practitioner 7517340185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Florida College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Physician Services, Inc.Group PAC ID 7113989849, 200 clinicians

Practice addresses (Care Compare)

601 5TH St S
Suite 5
St Petersburg, FL 33701-4804
Phone (727) 727-4429

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mariano D Cibran, MD Corp Dba St Petersburg Pediatrics CurrentSince Jun 22, 2021 Accepting new patients
Pediatric Physician Services, Inc. CurrentSince Jun 6, 2022 Accepting new patients
Mariano D Cibran, MD Corp Dba St Petersburg Pediatrics Pediatrics PastSince Aug 1, 2019 Accepting new patients

Locations

7500 Park Blvd N
Pinellas Park, FL 33781
Phone (727) 526-9135

601 5th St S
Ste 5
St Petersburg, FL 33701
Phone (727) 727-4429

2115 Central Ave
St Petersburg, FL 33713
Phone (727) 526-9135

601 5th St S
St Petersburg, FL 33701
Phone (727) 767-3333

501 6th Ave S
St Petersburg, FL 33701
Phone (727) 344-6060

Interoperability endpoints

  • Direct secure messaging: aspicochi@stpetepeds.opdirect.net
  • Direct secure messaging: aspicochi973875@direct.hopkinsmedicine.org

Organizations & group practices 3

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": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1407401631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 5TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-767-3636",
            "fax_number": "727-767-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 5TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-767-3636",
            "fax_number": "727-767-3638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7500 Park Blvd N",
            "address_purpose": "LOCATION",
            "city": "Pinellas Park",
            "state": "FL",
            "postal_code": "337813714",
            "country_code": "US",
            "telephone_number": "727-544-5437",
            "fax_number": "727-526-4346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPICOCHI",
        "first_name": "AMANDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11001691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.