Individual provider Active NPI

Anthony Louis Cardellio, D.O.

  • Family Medicine Physician
  • Shelby Township, MI
National Provider Identifier
1306865910
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101014635 Issued in MI
Practice address
50505 Schoenherr Rd Ste 230
Shelby Township, MI 48315-3140
Phone
(586) 803-3484
Fax
(586) 803-3354
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101014635 MI Primary

Addresses

Primary practice location

50505 Schoenherr Rd Ste 230
Shelby Township, MI 48315-3140

Mailing address

6483 Citation Dr Ste B
Clarkston, MI 48346-2994
Phone (248) 861-0010

Other practice location 1

585 South Blvd E Ste 100
Pontiac, MI 48341-3163
Phone (248) 206-1200

Other identifiers 2

IdentifierTypeStateIssuer
4501513MedicaidMI
1962158303OtherGROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2023 through Jan 1, 2027

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: acardellio17160@direct.hfhs.org
  • Direct secure messaging: anthony.cardellio.1@29818.direct.athenahealth.com
  • Direct secure messaging: acardellio1227942@epic00.shdirect.org

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1306865910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6483 CITATION DR STE B",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462994",
            "telephone_number": "248-861-0010",
            "fax_number": "248-861-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD STE 230",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153140",
            "telephone_number": "586-803-3484",
            "fax_number": "586-803-3354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "585 South Blvd E Ste 100",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483413163",
            "country_code": "US",
            "telephone_number": "248-206-1200",
            "fax_number": "248-206-1206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARDELLIO",
        "first_name": "ANTHONY",
        "middle_name": "LOUIS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101014635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4501513",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1962158303",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.