Individual provider Active NPI

Antonio Chatila

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1275014607
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F343716-1 Issued in NY
Practice address
1111 Amsterdam Ave
New York, NY 10025-1716
Phone
(212) 523-4000
NPI assigned
Aug 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9401252 FL
Family Nurse Practitioner 363LF0000X F343716-1 NY Primary

Addresses

Primary practice location

1111 Amsterdam Ave
New York, NY 10025-1716

Mailing address

50 W 93Rd St Apt 5N
New York, NY 10025-7666
Phone (305) 972-7099

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200428000688 NY Practitioner - Nurse Practitioner 5092145318 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9401252FLMDFamily Nurse Practitioner
F343716-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bronx Medical Practice P.C. CurrentSince Jun 1, 2020 Accepting new patients
Essen Medical Associates, PC CurrentSince Mar 1, 2020 Accepting new patients
Essen Medical Associates, PC CurrentSince Mar 1, 2020 Accepting new patients
Essen Medical Urgicare, PLLC CurrentSince Mar 1, 2020 Accepting new patients
Nicklaus Children'S Pediatric Specialists, LLC Past Accepting new patients

Locations

2015 Grand Concourse
#13202
Bronx, NY 10453

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366

8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

Organizations & group practices 5

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": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1275014607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 W 93RD ST APT 5N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100257666",
            "telephone_number": "305-972-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-523-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHATILA",
        "first_name": "ANTONIO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-23",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9401252",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F343716-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.