Individual provider Active NPI

Richard G D'Antonio, M.D.

  • Internal Medicine Physician
  • Cockeysville, MD
National Provider Identifier
1033147574
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D32929 Issued in MD
Practice address
12 Brecon PL
Ste. 410
Cockeysville, MD 21030-2343
Phone
(410) 825-3416
Fax
(410) 296-1796
NPI assigned
Jun 30, 2006
Last updated
Jan 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D32929 MD Primary

Addresses

Primary practice location

12 Brecon PL
Ste. 410
Cockeysville, MD 21030-2343

Mailing address

12 Brecon PL
Ste. 410
Cockeysville, MD 21030-2343
Phone (410) 825-3416

Other identifiers 1

IdentifierTypeStateIssuer
550891600MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081006000268 MD Practitioner - Internal MedicinePractitioner - Infectious Disease 7517035421 Practice locations: Cockeysville, MD

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph D'Antonio Jr., M.D., PHD, P.a. Past Accepting new patients

Organizations & group practices 1

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1033147574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BRECON PL",
            "address_2": "STE. 410",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210302343",
            "telephone_number": "410-825-3416",
            "fax_number": "410-296-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BRECON PL",
            "address_2": "STE. 410",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210302343",
            "telephone_number": "410-825-3416",
            "fax_number": "410-296-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ANTONIO",
        "first_name": "RICHARD",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D32929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "550891600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cockeysville, MD

Sources for this page

Verify at the official NPI Registry.