Individual provider Active NPI

Anthony Campo, M.D.

  • Psychiatry Physician
  • Wilton Manors, FL
National Provider Identifier
1316965924
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
170486 Issued in NY
Practice address
1432 NE 24TH St
Wilton Manors, FL 33305-1314
Phone
(561) 479-9256
Fax
(561) 930-9187
NPI assigned
Jul 18, 2006
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 170486 NY Primary
Psychiatry Physician 2084P0800X ME113410 FL

Addresses

Primary practice location

1432 NE 24TH St
Wilton Manors, FL 33305-1314

Mailing address

1432 NE 24TH St
Wilton Manors, FL 33305-1314
Phone (561) 479-9256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME113410FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caron of Florida, Inc Past Accepting new patients
Stony Brook Psychiatric Associates, University Faculty Practice Corpor Psychiatry PastSince Jul 23, 2015 Accepting new patients
Family Service League, Inc. Past Accepting new patients
Anthony Campo MD PC Psychiatry PastSince Apr 29, 2008 Accepting new patients
Park Avenue Medical Associates, P.C. PastSince Dec 4, 1999 Accepting new patients
Liberty Behavioral Health Associates Psychiatry Past Accepting new patients

Organizations & group practices 6

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.

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": "1744070400000",
    "number": "1316965924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 NE 24TH ST",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051314",
            "telephone_number": "561-479-9256",
            "fax_number": "561-930-9187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 NE 24TH ST",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051314",
            "telephone_number": "561-479-9256",
            "fax_number": "561-930-9187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPO",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "170486",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME113410",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton Manors, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.