Antonio Emmanuel Reisopoulos, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01470 Issued in RI

Practice address

7 Central St
Providence, RI 02907-2201

Phone

(401) 648-4700

NPI assigned

Jun 13, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Rhode Island Public Health FoundationGroup PAC ID 7810324597, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: antonio.reisopoulos.1@20649.direct.athenahealth.com

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.

• The Rhode Island Public Health Foundation

  • Clinic/Center
  • Providence, RI
  • NPI 1669024329
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1346970340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CENTRAL ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029072201",
            "telephone_number": "401-648-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CENTRAL ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029072201",
            "telephone_number": "401-648-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISOPOULOS",
        "first_name": "ANTONIO",
        "middle_name": "EMMANUEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Elizabeth Reilly, DPT
• Daniella P Reimann, MD
• Danielle Reinker, PHARMD
• Jessica Reis-Driscoll, LICSW
• Paula Reisler, PA-C
• Ira H Reiter, PH.D.
• Charlotte A Rekrut, CRNA
• Amy Remillard, LCSW
• Jennifer Remington, LMHC
• Nancy S Remington, RN,CNS

• Physician Assistant in Providence, RI
• Providers in Providence, RI by specialty
• Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.