Individual provider Active NPI

Anthony James Nigliazzo, M.D.

  • Surgery Physician
  • Berea, KY
National Provider Identifier
1235339433
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301090768 Issued in MI
Practice address
305 Estill St
Berea, KY 40403-1742
Phone
(859) 986-8418
NPI assigned
Jul 25, 2007
Last updated
Oct 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301090768 MI Primary

Addresses

Primary practice location

305 Estill St
Berea, KY 40403-1742

Mailing address

106 Hanover Dr
London, KY 40741-9775
Phone (260) 301-4062

Other practice location 1

303 S Main St
Bluffton, IN 46714-2503
Phone (260) 353-2021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190829004036 KY Practitioner - General Surgery 7012170632 Reassigns benefits to 1 organization
I20240515001682 OK Practitioner - Emergency MedicinePractitioner - General Surgery 7012170632 Reassigns benefits to 2 organizations
Practice locations: Atoka, OK

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: General Surgery
Education
University of Oklahoma College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Care Consultants IncGroup PAC ID 9032131735, 27 clinicians
Coal County General HospitalGroup PAC ID 8022901396, 6 clinicians

Practice addresses (Care Compare)

213 E Redwood Ave
Sallisaw, OK 74955-2811
Phone (918) 774-1100

6 N Covington St
Coalgate, OK 74538-2002
Phone 5809272327245

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301090768MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coal County General Hospital CurrentSince Aug 21, 2024 Accepting new patients
Coal County General Hospital CurrentSince Aug 21, 2024 Accepting new patients
Hospital Care Consultants, Inc CurrentSince Jan 6, 2026 Accepting new patients
Coal County General Hospital Past Accepting new patients
Sequoyah County City of Sallisaw Hospital Authority Past Accepting new patients

Locations

1668 W Liberty Rd
Atoka, OK 74525
Phone (580) 326-6423

6 N Covington St
Coalgate, OK 74538
Phone (580) 927-2327

1011 N Hinckley St
Holdenville, OK 74848
Phone (405) 592-3500

213 E Redwood Ave
Sallisaw, OK 74955
Phone (918) 774-1100

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1235339433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 HANOVER DR",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407419775",
            "telephone_number": "260-301-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 ESTILL ST",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031742",
            "telephone_number": "859-986-8418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 S Main St",
            "address_purpose": "LOCATION",
            "city": "Bluffton",
            "state": "IN",
            "postal_code": "467142503",
            "country_code": "US",
            "telephone_number": "260-353-2021",
            "fax_number": "260-919-3559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIGLIAZZO",
        "first_name": "ANTHONY",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301090768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, KY

Sources for this page

Verify at the official NPI Registry.