Individual provider Active NPI

Andrea D'Antonio, CPNP

  • Nurse Practitioner
  • South Kingstown, RI
National Provider Identifier
1760190748
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN04437 Issued in RI
Practice address
65 Village Square Dr
South Kingstown, RI 02879-2568
Phone
(401) 789-5924
Fax
(401) 782-1770
NPI assigned
Nov 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN04437 RI Primary

Addresses

Primary practice location

65 Village Square Dr
South Kingstown, RI 02879-2568

Mailing address

10 Davol SQ Ste 400
Providence, RI 02903-4752
Phone (401) 444-6779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, RI2 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
I20221223000239 NY Practitioner - Nurse Practitioner 2860862497 Reassigns benefits to 1 organization
I20250314000401 RI Practitioner - Nurse Practitioner 2860862497 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Institute for Family Health Current Accepting new patients
Coastal Medical Physicians, Inc. Nurse Practitioner CurrentSince Feb 1, 2025 Accepting new patients
Coastal Medical Physicians, Inc. CurrentSince Feb 1, 2025 Accepting new patients
Lifespan Corporation Current Accepting new patients
The Institute for Family Health CurrentSince Dec 7, 2022 Accepting new patients
Coastal Medical, Inc. Past Accepting new patients

Locations

16 E 16th St
New York, NY 10003
Phone (212) 633-0800

1824 Madison Ave
New York, NY 10035
Phone (212) 423-4200

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

65 Village Square Dr
Ste 201
South Kingstown, RI 02879
Phone (401) 515-7979

65 Village Square Dr
South Kingstown, RI 02879
Phone (401) 738-4323

Interoperability endpoints

  • Direct secure messaging: adantonio231548@brownhealth.medalliesdirect.net

Organizations & group practices 6

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": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1760190748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DAVOL SQ STE 400",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034752",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 VILLAGE SQUARE DR",
            "city": "SOUTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028792568",
            "telephone_number": "401-789-5924",
            "fax_number": "401-782-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ANTONIO",
        "first_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-09",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN04437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Kingstown, RI

Sources for this page

Verify at the official NPI Registry.