Antonette Otis Whitehead, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

261819 Issued in NY

Practice address

568 Broadway
Suite 304
New York, NY 10012-3225

Phone

(313) 215-3088

NPI assigned

Sep 2, 2007

Last updated

Dec 23, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Obstetrics/Gynecology

Education

Wayne State University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Square Care Medical Group LLPGroup PAC ID 7012938434, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: antonette.whitehead.1@15987.direct.athenahealth.com
• Direct secure messaging: awhitehead44994@nyumc.direct-ci.com
• FHIR API: https://api.platform.athenahealth.com/15987/brand/1/csg/1/fhir/r4

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.

• Square Care Medical Group, LLP

  • Obstetrics & Gynecology Physician
  • Woodbury, NY
  • NPI 1457392763
  Medicare reassignment Care Compare group NPD
• Downtown Women OB GYN Associates LLP

  • Gynecology Physician
  • New York, NY
  • NPI 1104015536
  Medicare reassignment NPD

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

{
    "created_epoch": "1188691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1073707071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 BROADWAY",
            "address_2": "SUITE 304",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100123225",
            "telephone_number": "313-215-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 BROADWAY",
            "address_2": "SUITE 304",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100123225",
            "telephone_number": "313-215-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "ANTONETTE",
        "middle_name": "OTIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-02",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "126062497",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "261819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Matthew White, MD
• Zilphia White, RN
• Zoe White, PHD
• Shaun Whited, DPT
• Coretta Whitehall
• Brittany Marie Whitehead, OTR/L
• Morgan Whitehead, LMSW
• Robert Steven Whitehead, R.PH
• Steven Whitehead, CASAC
• Jonathan Whitehouse, M.D.

• Obstetrics & Gynecology Physician in New York, NY
• Providers in New York, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.