Individual provider Active NPI

Amanda Guyer Trivino, FNP-BC

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1962922575
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5015608 Issued in NC
Practice address
125 Queens Rd Ste 610
Charlotte, NC 28204-3580
Phone
(980) 302-6600
Fax
(980) 302-6605
NPI assigned
Jun 23, 2017
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5015608 NC Primary
Family Nurse Practitioner 363LF0000X F342581 NY
Registered Nurse 163W00000X 714603-1 NY

Addresses

Primary practice location

125 Queens Rd Ste 610
Charlotte, NC 28204-3580

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

161 Fort Washington Ave
New York, NY 10032
Phone (646) 317-4805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 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
I20180706000117 NY Practitioner - Nurse Practitioner 9133475171 Reassigns benefits to 2 organizations
I20220314000640 NC Practitioner - Nurse Practitioner 9133475171 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
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians

Practice addresses (Care Compare)

125 Queens Rd
Charlotte, NC 28204-3215
Phone (980) 302-6450

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
714603-1NYMDRegistered Nurse
F342581NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital Current Accepting new patients
The Presbyterian Hospital CurrentSince May 1, 2022 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Sep 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York Nurse Practitioner CurrentSince Sep 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Sep 1, 2018 Accepting new patients
The Presbyterian Hospital CurrentSince May 1, 2022 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

125 Queens Rd
Charlotte, NC 28204
Phone (704) 384-5043

125 Queens Rd
Ste 610
Charlotte, NC 28204
Phone (980) 302-6600

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

630 W 168th St
New York, NY 10032
Phone (212) 305-1948

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

Interoperability endpoints

  • Direct secure messaging: atrivino1043167@direct.novanthealth.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 7

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 4

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": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1962922575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 610",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043580",
            "telephone_number": "980-302-6600",
            "fax_number": "980-302-6605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Fort Washington Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10032",
            "country_code": "US",
            "telephone_number": "646-317-4805",
            "fax_number": "212-305-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRIVINO",
        "first_name": "AMANDA",
        "middle_name": "GUYER",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5015608",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F342581",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "714603-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.