Adelaida B Antonio, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

C41801 Issued in CA

Practice address

21001 Sherman Way
Suite 15
Canoga Park, CA 91303-1760

Phone

(818) 716-0048

Fax

(818) 785-3330

NPI assigned

May 17, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Internal MedicineAlso: Family Practice, General Practice

Education

Other, 1954

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Roy Medical Group IncGroup PAC ID 1658682729, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Roy Medical Group, Inc.

  • General Practice Physician
  • Canoga Park, CA
  • NPI 1801921952

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Allmed of Los Angeles, Inc

  • Primary Care Clinic/Center
  • El Monte, CA
  • NPI 1053052522
  NPD (past)
• Lakeside Medical Associates, a Medical Group, Inc.

  dba Lakeside Community Healthcare Medical Group

  • Rheumatology Physician
  • Burbank, CA
  • NPI 1861499535
  NPD (past)
• Margarita Humanitarian Foundation

  • Federally Qualified Health Center (FQHC)
  • Palmdale, CA
  • NPI 1720619828
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323561600000",
    "number": "1134337975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21001 SHERMAN WAY",
            "address_2": "SUITE 15",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913031760",
            "telephone_number": "818-716-0048",
            "fax_number": "818-785-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21001 SHERMAN WAY",
            "address_2": "SUITE 15",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913031760",
            "telephone_number": "818-716-0048",
            "fax_number": "818-785-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIO",
        "first_name": "ADELAIDA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2011-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C41801",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "C41801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C418010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Andujo
• Angelic Home Health Care
• Angelic Home Health Care, Inc.
• Chandler Angelopulos
• Ann Tumberian
• Catherine Anz
• Aya Aparicio
• Aquazone Physical Therapy Inc
• Anna Ysabelle Arambulo
• Kelsey Araujo

• General Practice Physician in Canoga Park, CA
• Providers in Canoga Park, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2011; 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.