Individual provider Active NPI

Christopher Antonini, B.C.O.

  • Ocularist
  • Morgantown, WV
National Provider Identifier
1073885232
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OcularistTaxonomy code 156FX1700X
Practice address
Antonini Ocular Prosthetics, LLC
Wvu Eye Institute, 1 Medical Center Drive
Morgantown, WV 26506
Phone
(877) 594-0719
Fax
(304) 241-1858
NPI assigned
Feb 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ocularist 156FX1700X Primary

Addresses

Primary practice location

Antonini Ocular Prosthetics, LLC
Wvu Eye Institute, 1 Medical Center Drive
Morgantown, WV 26506

Mailing address

Antonini Ocular Prosthetics, LLC
1408 Far Meadows
Morgantown, WV 26508
Phone (877) 594-0719

Other identifiers 1

IdentifierTypeStateIssuer
381002299MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Antonini Ocular Prosthetics, LLC Ocularist CurrentSince Nov 20, 2022 Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1073885232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ANTONINI OCULAR PROSTHETICS, LLC",
            "address_2": "1408 FAR MEADOWS",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26508",
            "telephone_number": "877-594-0719",
            "fax_number": "364-241-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ANTONINI OCULAR PROSTHETICS, LLC",
            "address_2": "WVU EYE INSTITUTE, 1 MEDICAL CENTER DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26506",
            "telephone_number": "877-594-0719",
            "fax_number": "304-241-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONINI",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "B.C.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-03",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ocularist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381002299",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.