Individual provider Active NPI

Anthony John Antonelli, APRN

  • Family Nurse Practitioner
  • Dunedin, FL
National Provider Identifier
1396570883
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11032930 Issued in FL
Practice address
1440 Main St
Dunedin, FL 34698-6249
Phone
(727) 275-9120
NPI assigned
Sep 4, 2024
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11032930 FL Primary

Addresses

Primary practice location

1440 Main St
Dunedin, FL 34698-6249

Mailing address

3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone (813) 615-7000

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250113001608 FL Practitioner - Nurse Practitioner 0244768687 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tampa Bay Emergency Physicians, LLCGroup PAC ID 0345260345, 55 clinicians

Practice addresses (Care Compare)

3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone (813) 971-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11032930FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Bay Emergency Physicians-Heartland LLC CurrentSince Feb 1, 2025 Accepting new patients
Tampa Bay Emergency Physicians LLC CurrentSince Feb 1, 2025 Accepting new patients
Unique Healthcare Systems LLC CurrentSince Sep 23, 2024 Accepting new patients
Unique Management Group PastSince Sep 8, 2024 Accepting new patients

Locations

1440 Main St
Dunedin, FL 34698
Phone (727) 201-8585

7101 US Highway 19 N
Pinellas Park, FL 33781
Phone (727) 201-8585

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

7171 N Dale Mabry Hwy
Tampa, FL 33614
Phone (813) 558-8001

1395 S Pinellas Ave
Tarpon Springs, FL 34689
Phone (727) 942-5000

735 S 5th Ave
Wauchula, FL 33873
Phone (863) 402-3402

Organizations & group practices 4

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": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1396570883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134613",
            "telephone_number": "813-615-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 MAIN ST",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346986249",
            "telephone_number": "727-275-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONELLI",
        "first_name": "ANTHONY",
        "middle_name": "JOHN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-04",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11032930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunedin, FL

Sources for this page

Verify at the official NPI Registry.