Stephanie Ann Moody Antonio, MD

Primary specialty

Otology & Neurotology PhysicianTaxonomy code 207YX0901X

License

0101237385 Issued in VA

Practice address

600 Gresham Dr
Suite 1100
Norfolk, VA 23507-1904

Phone

(757) 388-6200

Fax

(757) 388-6201

NPI assigned

Feb 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 17

Medicare fee-for-service enrollment

Enrolled in VA

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.

Enrollment records 1

Specialty

Otolaryngology

Education

Indiana University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evms Academic Physicians and Surgeons Health Services FoundationGroup PAC ID 5698675510, 228 clinicians

Childrens Specialty Group PLLCGroup PAC ID 5890788764, 89 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
• Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
• Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
• Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
• Sentara Albemarle Medical Center Hospital, Elizabeth City, NC, CCN 340109

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Childrens Specialty Group PLLC

  • Pediatrics Physician
  • Norfolk, VA
  • NPI 1255354130
  Medicare reassignment Care Compare group NPD
• Evms Academic Physicians and Surgeons Health Services Foundation

  • Internal Medicine Physician
  • Norfolk, VA
  • NPI 1003887118

  Otolaryngology

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sentara Hospitals

  • Air Ambulance
  • Norfolk, VA
  • NPI 1235205147

  Hospital

  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1437119310
  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1629038336
  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1811957681
  Care Compare affiliation
• Sentara Princess Anne Hospital

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1528028396
  Care Compare affiliation
• Sentara Albemarle Regional Medical Center

  • General Acute Care Hospital
  • Elizabeth City, NC
  • NPI 1245211168
  Care Compare affiliation

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232928000000",
    "number": "1366418956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235010936",
            "telephone_number": "757-388-6200",
            "fax_number": "757-388-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR",
            "address_2": "SUITE 1100",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-6200",
            "fax_number": "757-388-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY ANTONIO",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2009-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101237385",
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "VA",
            "license": "0101237385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "174750",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH COMMERCIAL",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "067RG",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "172403",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA OPTIMA",
            "identifier": "91377",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA PREMIER HEALTH",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "-004",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010170095",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA HEALTH NETWORK",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORVEL/CORCARE",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010118387",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC/MAMSI",
            "identifier": "2129791",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89067RG",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela F. Montgomery, LPC
• Natalie Montgomery
• Thomas R Montgomery, M.D.
• Tyson Montgomery, OD
• Megan Mooberry, MD
• Perounsack X Moon, DO
• Moore Comfort Home Care LLC
• Leimeredith Lapri Moore-Byers, PA-C
• Alexandra Carney Moore, PA
• Andrew Moore, MD

• Otology & Neurotology Physician in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Otology & Neurotology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; 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.