Individual provider Active NPI

Amanda D'Ercole, APRN

  • Family Nurse Practitioner
  • Johnston, RI
National Provider Identifier
1700437894
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11004327 Issued in FL
Practice address
1524 Atwood Ave
Johnston, RI 02919-3228
Phone
(401) 273-9400
NPI assigned
Sep 20, 2019
Last updated
Apr 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11004327 FL Primary
Registered Nurse 163W00000X RN9290794 FL

Addresses

Primary practice location

1524 Atwood Ave
Johnston, RI 02919-3228

Mailing address

673 NE 3Rd Ave Apt 224
Fort Lauderdale, FL 33304-2723
Phone (401) 230-4798

Other practice location 1

673 NE 3rd Ave Apt 224
Fort Lauderdale, FL 33304-2723
Phone (401) 230-4798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, FL2 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
I20240730000623 RI Practitioner - Nurse Practitioner 6204373020 Reassigns benefits to 1 organization
I20250925005009 FL Practitioner - Nurse Practitioner 6204373020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atmed Treatment Center, Inc.Group PAC ID 4587655543, 11 clinicians

Practice addresses (Care Compare)

1524 Atwood Ave
Suite 122
Johnston, RI 02919-3228
Phone (401) 273-9400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9290794FLMDRegistered Nurse
11004327FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Physiatry Group LLC CurrentSince Aug 25, 2025 Accepting new patients
Atmed Treatment Center, Inc. CurrentSince May 17, 2024 Accepting new patients

Locations

5493 Wiles Rd
Ste 106
Coconut Creek, FL 33073
Phone (321) 214-4530

1524 Atwood Ave
Ste 122
Johnston, RI 02919
Phone (401) 273-9400

850 Central Pkwy E
Ste 275
Plano, TX 75074

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1700437894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 NE 3RD AVE APT 224",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333042723",
            "telephone_number": "401-230-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 ATWOOD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193228",
            "telephone_number": "401-273-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "673 NE 3rd Ave Apt 224",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333042723",
            "country_code": "US",
            "telephone_number": "401-230-4798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "D'ERCOLE",
        "first_name": "AMANDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-20",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11004327",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9290794",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, RI

Sources for this page

Verify at the official NPI Registry.