Active NPI
Anthony Louis Cardellio, D.O.
- Family Medicine Physician
- Shelby Township, MI
National Provider Identifier
1306865910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5101014635
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4501513 | Medicaid | MI | |
| 1962158303 | Other | GROUP 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
- 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
- acardellio17160@direct.hfhs.org
- anthony.cardellio.1@29818.direct.athenahealth.com
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.