NPIMap

Individual provider Active NPI

Michelle E Antiles, DO

  • Physical Medicine & Rehabilitation Physician
  • Schenectady, NY
National Provider Identifier
1306811237
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
191554 Issued in NY
Practice address
1270 Belmont Ave
Schenectady, NY 12308-2104
Phone
(518) 382-4560
Fax
(518) 386-3619
NPI assigned
Feb 22, 2006
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 191554 NY Primary
Physical Medicine & Rehabilitation Physician 208100000X 19155455 NY
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician 2081H0002X 191554 NY

Addresses

Primary practice location

1270 Belmont Ave
Schenectady, NY 12308-2104

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other identifiers 1

IdentifierTypeStateIssuer
01788852MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100825000474 NY Practitioner - Physical Medicine and Rehabilitation 7315061546 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of New England, College of Osteo Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunnyview Hospital and Rehabilitation CenterGroup PAC ID 5496743072, 31 clinicians

Practice addresses (Care Compare)

1270 Belmont Ave
Schenectady, NY 12308-2104
Phone (518) 382-4500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19155455NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunnyview Hospital and Rehabilitation Center Physical Medicine & Rehabilitation CurrentSince Mar 18, 2019 Accepting new patients
St. Peter's Health Partners Medical Associates, P.C. CurrentSince Apr 1, 2019 Accepting new patients

Locations

5 Palisades Dr
Ste 200
Albany, NY 12205
Phone (518) 438-0019

1270 Belmont Ave
Schenectady, NY 12308
Phone (518) 382-4500

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

Interoperability endpoints

  • Direct secure messaging: mantiles788105@direct.trinity-health.org

Organizations & group practices 2

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 9

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1306811237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 BELMONT AVE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123082104",
            "telephone_number": "518-382-4560",
            "fax_number": "518-386-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTILES",
        "first_name": "MICHELLE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "191554",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "19155455",
            "primary": false
        },
        {
            "code": "2081H0002X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "191554",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01788852",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP- Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1270 Belmont Ave",
            "city": "Schenectady",
            "state": "NY",
            "country_code": "US",
            "postal_code": "123082104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.