NPIMap

Organization Active NPI

Emerald Coast Infectious Diseases Medical Group, P.a.

Doing business as American Medical Group

  • Infectious Disease Physician
  • Fort Walton Beach, FL
National Provider Identifier
1720017882
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
EMERALD COAST INFECTIOUS DISEASES MEDICAL GROUP, P.A.
Doing business as
American Medical Group
Bay, Foot, and Ankle Center
Practice address
917 Mar Walt Dr
Fort Walton Beach, FL 32547-6651
Phone
(850) 862-3979
NPI assigned
Jul 1, 2006
Last updated
Mar 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Authorized official

Name
Eric Squatrito
Title
Ceo
Phone
(850) 786-2270

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Allergy & Immunology (Internal Medicine) Physician 207RA0201X NU
Critical Care Medicine (Internal Medicine) Physician 207RC0200X NU
Gastroenterology Physician 207RG0100X NU
Infectious Disease Physician 207RI0200X NU Primary
Pulmonary Disease Physician 207RP1001X NU
Rheumatology Physician 207RR0500X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU

Addresses

Primary practice location

917 Mar Walt Dr
Fort Walton Beach, FL 32547-6651

Mailing address

917 Mar Walt Dr
Fort Walton Beach, FL 32547-6651
Phone (850) 862-3979

Other practice location 1

1921 E Nine Mile Rd
Pensacola, FL 32514-7747
Phone (850) 999-5837

Other practice location 2

1326 Lewis Turner Blvd
Fort Walton Beach, FL 32547-1139
Phone (850) 855-4048

Other practice location 3

417 Racetrack Rd NW
Fort Walton Beach, FL 32547-4612
Phone (850) 862-3979

Other practice location 4

137 Crystal Beach Dr Ste 121
Destin, FL 32541-3573
Phone (850) 807-4388

Other practice location 5

1710 Lisenby Ave
Panama City, FL 32405-3730
Phone (850) 807-4420

Other practice location 6

1025 Beal Pkwy N Ste C
Fort Walton Beach, FL 32547-1481
Phone (850) 374-3806

Other practice location 7

1025 Beal Pkwy N Ste A
Fort Walton Beach, FL 32547-1481
Phone (850) 374-8220

Other practice location 8

351 N Ferdon Blvd
Crestview, FL 32536-2727
Phone (850) 862-3979

Other names 2

  • American Medical Group Doing business as
  • Bay, Foot, and Ankle Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050422000315 FL Part B Supplier - Clinic/Group Practice 5092753772 Receives reassigned benefits from 35 practitioners
Practice locations: Fort Walton Beach, FL; Pensacola, FL; Panama City, FL; Destin, FL; Crestview, FL
O20170724001257 FL DME Supplier - Physician - Infectious DiseaseDME Supplier - Physician - Internal Medicine 5092753772 Practice locations: Fort Walton Beach, FL

National Provider Directory

National Provider Directory
Tax ID family
Emerald Coast Infectious Diseases Medical Group PA7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1025 Beal Pkwy N
Ste A
Ft Walton Bch, FL 32547
Phone (850) 374-8220

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1720017882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476651",
            "telephone_number": "850-862-3979",
            "fax_number": "850-862-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476651",
            "telephone_number": "850-862-3979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1921 E Nine Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325147747",
            "country_code": "US",
            "telephone_number": "850-999-5837",
            "fax_number": "850-862-0605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1326 Lewis Turner Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325471139",
            "country_code": "US",
            "telephone_number": "850-855-4048",
            "fax_number": "850-855-4068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "417 Racetrack Rd NW",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325474612",
            "country_code": "US",
            "telephone_number": "850-862-3979",
            "fax_number": "850-862-0605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "137 Crystal Beach Dr Ste 121",
            "address_purpose": "LOCATION",
            "city": "Destin",
            "state": "FL",
            "postal_code": "325413573",
            "country_code": "US",
            "telephone_number": "850-807-4388",
            "fax_number": "850-862-0605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1710 Lisenby Ave",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324053730",
            "country_code": "US",
            "telephone_number": "850-807-4420",
            "fax_number": "850-862-0605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Beal Pkwy N Ste C",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325471481",
            "country_code": "US",
            "telephone_number": "850-374-3806",
            "fax_number": "850-862-0605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Beal Pkwy N Ste A",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325471481",
            "country_code": "US",
            "telephone_number": "850-374-8220",
            "fax_number": "850-862-0605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "351 N Ferdon Blvd",
            "address_purpose": "LOCATION",
            "city": "Crestview",
            "state": "FL",
            "postal_code": "325362727",
            "country_code": "US",
            "telephone_number": "850-862-3979",
            "fax_number": "850-862-0605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMERALD COAST INFECTIOUS DISEASES MEDICAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "SQUATRITO",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-786-2270"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bay, Foot, and Ankle Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.