NPIMap

Individual provider Active NPI

Amanda J. Fernandes, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Riverside, RI
National Provider Identifier
1649602863
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD16760 Issued in RI
Practice address
375 Wampanoag TRL
Riverside, RI 02915
Phone
(401) 649-4090
NPI assigned
Jul 30, 2013
Last updated
Jul 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD16760 RI Primary

Addresses

Primary practice location

375 Wampanoag TRL
Riverside, RI 02915

Mailing address

110 Elm St FL 2
Providence, RI 02903-4626
Phone (401) 443-4992

Other practice location 1

245 Chapman St Ste 300
Providence, RI 02905-4539
Phone (401) 444-4741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190719000507 RI Practitioner - Endocrinology 1759517980 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians
Brown MedicineGroup PAC ID 0446159776, 220 clinicians
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

245 Chapman St
Suite 300
Providence, RI 02905-4539
Phone (401) 444-5280

375 Wampanoag TRL
Riverside, RI 02915-2232
Phone (401) 649-4010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Sep 1, 2019 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Brown Medicine Endocrinology, Diabetes & Metabolism CurrentSince Sep 1, 2019 Accepting new patients
Lifespan Physician Group Inc CurrentSince Jan 1, 2026 Accepting new patients
Brown Medicine CurrentSince Sep 1, 2019 Accepting new patients
Rhode Island Hospital CurrentSince Sep 1, 2019 Accepting new patients
Brown Medicine Endocrinology, Diabetes & Metabolism Past Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

110 Elm St
Providence, RI 02903
Phone (401) 443-4992

110 Elm St
Fl 2
Providence, RI 02903

245 Chapman St
Ste 300
Providence, RI 02905
Phone (401) 444-4741

593 Eddy St
Providence, RI 02903

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

375 Wampanoag Trl
Riverside, RI 02915
Phone (401) 649-4010

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJFJAA

Organizations & group practices 9

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 8

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": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1649602863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 ELM ST FL 2",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034626",
            "telephone_number": "401-443-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 WAMPANOAG TRL",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "02915",
            "telephone_number": "401-649-4090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Chapman St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029054539",
            "country_code": "US",
            "telephone_number": "401-444-4741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "AMANDA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-30",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "RI",
            "license": "MD16760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

Verify at the official NPI Registry.