Active NPI
Jorge M Antonetti, PA
- Physician Assistant
- Schenectady, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 009973-1
- Practice address
- 1101 Nott St
@ Ellis Hospital ER Dept.
Schenectady, NY 12308-2425 - Phone
- (518) 243-4121
- Fax
- (518) 383-4223
- NPI assigned
- Jun 28, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 009973-1 | NY | Primary |
Addresses
Primary practice location
1101 Nott St
@ Ellis Hospital ER Dept.
Schenectady, NY 12308-2425
Mailing address
PO Box 1351
Schenectady, NY 12301-1351
Phone (518) 470-4589
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02619065 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040823001160 | NY | Practitioner - Physician Assistant | 3072587385 | Reassigns benefits to 15 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bertrand Chaffee Hospital
Practice addresses (Care Compare)
224 E Main St
Springville, NY 14141-1443
Phone 71659228711202
Hospital & facility affiliations
- River Hospital Clinics
- Bertrand Chaffee Hospital
- Medina Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009973-1 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elizabethtown Community Hospital | Current | Accepting new patients | |
| Nes Medical Services of New York PC | Current | Accepting new patients | |
| St. Mary'S Healthcare | Current | Accepting new patients | |
| Ellis Hospital | Current | Accepting new patients | |
| United Medical Associates PC | Current | Accepting new patients | |
| St Marys Healthcare | Current | Accepting new patients | |
| Northeast Emergency Medical Associates, PC | Past | Accepting new patients | |
| Nes Medical Services of New York PC | Past | Accepting new patients |
Locations
427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404
4950 State Highway 30
Amsterdam, NY 12010
Phone (518) 770-7557
7571 State Route 54
Bath, NY 14810
Phone (607) 776-8500
33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156
103 Sitterly Rd
Halfmoon, NY 12065
Phone (518) 579-2700
33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412
1101 Nott St
Unit C1
Schenectady, NY 12308
1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916
200 Harborside Dr
Schenectady, NY 12305
Phone (518) 881-4470
7 Timmerman Ave
St Johnsville, NY 13452
Phone (518) 568-5037
Interoperability endpoints
- jantonetti469207@direct.uvmhealth.org
- jantonetti26723@direct.xtensys.com
- https://fhir-usa.unify.chbase.com/org/elizabe-e663f886
- jorge_antonetti@yourcarecommunity.org
Organizations & group practices 18
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.
-
- Emergency Medicine Physician
- Syracuse, NY
- NPI 1639236656
NY
-
- Emergency Medicine Physician
- Poughkeepsie, NY
- NPI 1093759847
NY
-
- Emergency Medicine Physician
- Gloversville, NY
- NPI 1518205491
NY
-
- Emergency Medicine Physician
- Far Rockaway, NY
- NPI 1639160385
NY
-
- Emergency Medicine Physician
- Springville, NY
- NPI 1952331761
NY
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Medicare Defined Swing Bed Hospital Unit
- Alexandria Bay, NY
- NPI 1821022781
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1366470692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1351",
"city": "SCHENECTADY",
"state": "NY",
"postal_code": "123011351",
"telephone_number": "518-470-4589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 NOTT ST",
"address_2": "@ ELLIS HOSPITAL ER DEPT.",
"city": "SCHENECTADY",
"state": "NY",
"postal_code": "123082425",
"telephone_number": "518-243-4121",
"fax_number": "518-383-4223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTONETTI",
"first_name": "JORGE",
"middle_name": "M",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "009973-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02619065",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Schenectady, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.