Individual provider Active NPI

Pavel Antonov, M.D.

  • Emergency Medicine Physician
  • Miami, FL
National Provider Identifier
1285089789
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35.135526 Issued in OH
Practice address
11750 SW 40TH St
Miami, FL 33175-3530
Phone
(315) 223-3000
NPI assigned
May 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 35.135526 OH Primary

Addresses

Primary practice location

11750 SW 40TH St
Miami, FL 33175-3530

Mailing address

11750 SW 40TH St
Miami, FL 33175-3530
Phone (315) 223-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 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
I20201120000345 TX Practitioner - Emergency Medicine 0941594626 Reassigns benefits to 3 organizations
I20250305000901 FL Practitioner - Emergency Medicine 0941594626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of FL LLCGroup PAC ID 8426413931, 686 clinicians

Practice addresses (Care Compare)

5301 S Congress Ave
HCA Florida JFK Medical Center
Atlantis, FL 33462-1197
Phone (561) 965-7300

Hospital & facility affiliations

  • HCA Florida JFK Hospital Hospital, Atlantis, FL, CCN 100080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.135526OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rio Grande Valley Emergency Physicians PLLC Emergency Medicine CurrentSince Nov 21, 2020 Accepting new patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Oct 20, 2021 Accepting new patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Dec 20, 2024 Accepting new patients
Emergency Medicine Services of TX, PLLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

5301 S Congress Ave
Fl Jfk
Atlantis, FL 33462
Phone (561) 236-9361

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

100 E Alton Gloor Blvd
#A
Brownsville, TX 78526
Phone (956) 350-7000

100 E Alton Gloor Blvd
Brownsville, TX 78526
Phone (956) 350-7000

2744 W University Dr
Edinburg, TX 78539
Phone (956) 380-8080

225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400

2101 Pease St
Harlingen, TX 78550
Phone (956) 369-1100

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

101 E Ridge Rd
McAllen, TX 78503
Phone (956) 632-6000

5100 W Expressway 83
McAllen, TX 78501
Phone (956) 928-7200

900 S Bryan Rd
Mission, TX 78572
Phone (956) 323-9000

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

200 E Interstate 2
San Juan, TX 78589
Phone (956) 782-3300

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

605 Holderrieth Blvd
Tomball, TX 77375
Phone (281) 401-7500

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1285089789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11750 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753530",
            "telephone_number": "315-223-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11750 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753530",
            "telephone_number": "315-223-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONOV",
        "first_name": "PAVEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-03",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.135526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.