Amanda Marie Antonino, APRN is a medicare enrolled "Nurse Practitioner - Adult Health" in Bozrah, Connecticut. She graduated from nursing school in 2016 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice The William W Backus Hospital and her current practice location is
197 Fitchville Rd, Apt 5, Bozrah, Connecticut. You can reach out to her office (for appointments etc.) via phone at
(186) 028-7270.
Amanda Marie Antonino is licensed to practice in Connecticut (license number 6802) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1679012751.
Provider's Profile
Full Name | Amanda Marie Antonino |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Experience | 8 Years |
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Location | 197 Fitchville Rd, Bozrah, Connecticut |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Amanda Marie Antonino graduated from nursing school in 2016
NPI Data:
- NPI Number: 1679012751
- Provider Enumeration Date: 02/22/2017
- Last Update Date: 02/22/2017
Medicare PECOS Information:
- PECOS PAC ID: 4183991664
- Enrollment ID: I20170605002221
Medical Identifiers
Medical identifiers for Amanda Marie Antonino such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1679012751 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LA2200X | Nurse Practitioner - Adult Health | 6802 (Connecticut) | Primary |
363LG0600X | Nurse Practitioner - Gerontology | 6802 (Connecticut) | Secondary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
The William W Backus Hospital | 0749170645 | 175 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amanda Marie Antonino allows following entities to bill medicare on her behalf.
Entity Name | The William W Backus Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1467517235 PECOS PAC ID: 0749170645 Enrollment ID: O20040316000739 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Marie Antonino is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Amanda Marie Antonino, APRN 197 Fitchville Rd, Apt 5, Bozrah, CT 06334-1135 Ph: (186) 028-7270 | Amanda Marie Antonino, APRN 197 Fitchville Rd, Apt 5, Bozrah, CT 06334-1135 Ph: (186) 028-7270 |
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