Individual provider Active NPI

Jeffrey Antimarino, M.D.

  • Plastic Surgery Physician
  • Pittsburgh, PA
National Provider Identifier
1417067760
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD430564 Issued in PA
Practice address
5301 Fifth Ave
Pittsburgh, PA 15232
Phone
(844) 496-6647
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X G81237 CA
Plastic Surgery Physician 208200000X MD430564 PA Primary

Addresses

Primary practice location

5301 Fifth Ave
Pittsburgh, PA 15232

Mailing address

5301 Fifth Ave
Pittsburgh, PA 15232
Phone (844) 496-6647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070319000568 PA Practitioner - Plastic and Reconstructive Surgery 5597652768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Creighton University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellissimo Plastic Surgery LLCGroup PAC ID 5294044665, 2 clinicians

Practice addresses (Care Compare)

117 Fox Plan Rd
Suite 300
Monroeville, PA 15146-2723
Phone (844) 496-6647

5301 5TH Ave
Suite a
Pittsburgh, PA 15232-2194
Phone (844) 496-6647

Hospital & facility affiliations

  • Forbes Hospital Hospital, Monroeville, PA, CCN 390267

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision12
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD430564PAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bellissimo Plastic Surgery LLC CurrentSince Apr 1, 2015 Accepting new patients
Rancho Faculty Medical Associates, Inc. Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

117 Fox Plan Rd
Ste 300
Monroeville, PA 15146
Phone (844) 496-6647

5989 Centre Ave
Pittsburgh, PA 15206
Phone (412) 345-0061

Interoperability endpoints

  • Direct secure messaging: jantimarino@direct.excelahealth.org

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 and National Provider Directory roles.

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1417067760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 FIFTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15232",
            "telephone_number": "844-496-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 FIFTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15232",
            "telephone_number": "844-496-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTIMARINO",
        "first_name": "JEFFREY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "G81237",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD430564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.