Individual provider Active NPI

John G Antonakakis, MD

  • Anesthesiology Physician
  • Charlottesville, VA
National Provider Identifier
1386851244
Registry record updated Oct 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0101242954 Issued in VA
Practice address
Uva Hospital
Lee Street, 2ND Floor
Charlottesville, VA 22908-0001
Phone
(434) 924-2283
Fax
(434) 982-0019
NPI assigned
May 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101242954 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X 116015815 VA

Addresses

Primary practice location

Uva Hospital
Lee Street, 2ND Floor
Charlottesville, VA 22908-0001

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007
Phone (434) 295-1000

Other identifiers 1

IdentifierTypeStateIssuer
1386851244MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20070720000074 NH Practitioner - Anesthesiology 2860593837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Vermont College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portsmouth Anesthesia Associates PAGroup PAC ID 6002855327, 40 clinicians
Stratham Anesthesia Associates PLLCGroup PAC ID 7416007950, 26 clinicians

Practice addresses (Care Compare)

333 Borthwick Ave
Portsmouth, NH 03801-7128
Phone (603) 436-5110

4 W Rd
Suite B1
Stratham, NH 03885-2612
Phone (603) 772-2076

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
116015815VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Stratham Anesthesia Associates PLLC Anesthesiology CurrentSince Oct 1, 2020 Accepting new patients
Portsmouth Anesthesia Associates PA Anesthesiology CurrentSince Sep 20, 2009 Accepting new patients
University of Virginia Physicians Group PastSince Nov 1, 2017 Accepting new patients

Locations

333 Bothwick Ave
Portsmouth, NH 03801
Phone (603) 433-4907

16 Keewaydin Dr
Salem, NH 03079
Phone (603) 401-6466

4 West Rd
Ste B1
Stratham, NH 03885
Phone (603) 772-2076

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223596800000",
    "number": "1386851244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007",
            "telephone_number": "434-295-1000",
            "fax_number": "434-972-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UVA HOSPITAL",
            "address_2": "LEE STREET, 2ND FLOOR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080001",
            "telephone_number": "434-924-2283",
            "fax_number": "434-982-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONAKAKIS",
        "first_name": "JOHN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2008-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101242954",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "116015815",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386851244",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.