Active NPI
Amy G. Lafontaine, P.A.
- Physician Assistant
- North Providence, RI
National Provider Identifier
1659346104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 00362
- Practice address
- 200 High Service Ave
North Providence, RI 02904-5113 - Phone
- (401) 456-3000
- NPI assigned
- Feb 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 00362 | RI | Primary |
Addresses
Primary practice location
200 High Service Ave
North Providence, RI 02904-5113
Mailing address
45 Cooper Rd
Chepachet, RI 02814-1444
Phone (401) 808-0165
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 29687-6 | Other | RI | BLUECROSS BLUESHIELD |
| 9004038 | Medicaid | RI | |
| 412788 | Other | RI | BLUE CHIP |
| P00309459 | Other | RI | RAILROAD |
Other names 1
- Amy G Burlingame
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
106 Nate Whipple Hwy
Suite 101
Cumberland, RI 02864-1403
Phone (401) 658-2020
400 Putnam Pike
Smithfield, RI 02917-2408
Phone (401) 757-6160
982 Tiogue Ave
Coventry, RI 02816-6116
Phone (401) 821-6800
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00362 | RI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mdri LLC | Past | Accepting new patients |
Interoperability endpoints
- amy.lafontaine.1@31278.direct.athenahealth.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Cumberland, RI
- NPI 1598341067
-
- Internal Medicine Physician
- Johnston, RI
- NPI 1558490151
-
- Urgent Care Clinic/Center
- Lincoln, RI
- NPI 1437119005
-
dba Blackstone Valley Medicine
- Primary Care Clinic/Center
- East Greenwich, RI
- NPI 1922887157
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Kent County Hospital Rehab Unit
- Rehabilitation Hospital Unit
- Warwick, RI
- NPI 1023017944
-
- General Acute Care Hospital
- Warwick, RI
- NPI 1386643294
-
- General Acute Care Hospital
- Providence, RI
- NPI 1487649430
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329091200000",
"number": "1659346104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 COOPER RD",
"city": "CHEPACHET",
"state": "RI",
"postal_code": "028141444",
"telephone_number": "401-808-0165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HIGH SERVICE AVE",
"city": "NORTH PROVIDENCE",
"state": "RI",
"postal_code": "029045113",
"telephone_number": "401-456-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAFONTAINE",
"first_name": "AMY",
"middle_name": "G.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-20",
"last_updated": "2012-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "RI",
"license": "00362",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "29687-6",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9004038",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "412788",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00309459",
"state": "RI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "BURLINGAME",
"middle_name": "G",
"credential": "PA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in North Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.