Active NPI
Elie Antebi, M.D.
- Urology Physician
- Miami, FL
National Provider Identifier
1104157239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- ME107942
- Practice address
- 1611 NW 12TH Ave
Miami, FL 33136-1005 - Phone
- (305) 243-3670
- NPI assigned
- Jan 29, 2010
- Last updated
- Aug 20, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | ME107942 | FL | Primary |
| Urology Physician | 208800000X | 342240 | NY |
Addresses
Primary practice location
1611 NW 12TH Ave
Miami, FL 33136-1005
Mailing address
111 Colchester Ave
Burlington, VT 05401-1473
Other practice location 1
15 Degrandpre Way
Plattsburgh, NY 12901-6449
Phone (518) 314-3900
Other practice location 2
75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 314-3900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 342240 | NY | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Miami | Urology | 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": "1264723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787184000000",
"number": "1104157239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 COLCHESTER AVE",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054011473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 NW 12TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361005",
"telephone_number": "305-243-3670"
}
],
"practiceLocations": [
{
"address_1": "15 Degrandpre Way",
"address_purpose": "LOCATION",
"city": "Plattsburgh",
"state": "NY",
"postal_code": "129016449",
"country_code": "US",
"telephone_number": "518-314-3900",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "75 Beekman St",
"address_purpose": "LOCATION",
"city": "Plattsburgh",
"state": "NY",
"postal_code": "129011438",
"country_code": "US",
"telephone_number": "518-314-3900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANTEBI",
"first_name": "ELIE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-01-29",
"last_updated": "2026-08-20",
"certification_date": "2026-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "FL",
"license": "ME107942",
"primary": true
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NY",
"license": "342240",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.