Rex Antinozzi, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

RA049843 Issued in MI

Practice address

4100 Park Forest Dr
Suite 208
Traverse City, MI 49684-7331

Phone

(231) 935-5710

Fax

(231) 935-9045

NPI assigned

Dec 13, 2006

Last updated

Aug 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Digestive Health Associates of Northern Michigan, P.C.

  • Gastroenterology Physician
  • Traverse City, MI
  • NPI 1225104011
  Medicare reassignment NPD
• Northwest Michigan Surgery Center LLC

  dba Copper Ridge Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Traverse City, MI
  • NPI 1518957729
  NPD

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219968000000",
    "number": "1427119429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR",
            "address_2": "SUITE 208",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847331",
            "telephone_number": "231-935-5710",
            "fax_number": "231-935-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR",
            "address_2": "SUITE 208",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847331",
            "telephone_number": "231-935-5710",
            "fax_number": "231-935-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTINOZZI",
        "first_name": "REX",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "RA049843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "OB81010",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4343067",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Ann Anglin
• Ankle & Foot Associates PLLC
• Anna Lammers OD PLLC
• Jodie E. Annis, LMSW
• Anthony E Bozzio MDPC
• Paige Anton
• Anya Nyson, LLC
• Apex Diagnostics LLC
• Jira Apinyawat, R.PH, M.S.
• Apollo Medical Group of Traverse City PLLC

• Gastroenterology Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.