Active NPI
Eduardo Santiago Antonio Jr., PA
- Emergency Medicine Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 0004771
- Practice address
- 1879 Madison Ave
New York, NY 10035-2709 - Phone
- (212) 423-4262
- NPI assigned
- Sep 29, 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 0004771 | NY | Primary |
Addresses
Primary practice location
1879 Madison Ave
New York, NY 10035-2709
Mailing address
80 Charlotte PL
Hartsdale, NY 10530-2602
Phone (914) 625-4568
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
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 85.32
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004771 | NY | MD | Acupuncturist |
| 0004771 | NY | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Emergency Medicine | Current | Accepting new patients |
| Montefiore Medical Center | Emergency Medicine | Past | Accepting new patients |
| Madison Avenue Emergency Medicine PC | Emergency Medicine | Past | Accepting new patients |
Locations
1980 Crompond Rd
Cortlandt Mnr, NY 10567
Phone (914) 734-3600
12 N 7th Ave
Mount Vernon, NY 10550
Phone (914) 361-6511
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
622 W 168th St
Ph 1137
New York, NY 10032
Phone (212) 305-2575
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- esa9013@direct.nyp.org
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Fort Lee, NJ
- NPI 1982993184
NY
-
- Surgery Physician
- New York, NY
- NPI 1508266347
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
Emergency Medicine
-
- Emergency Medicine Physician
- New York, NY
- NPI 1073686739
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427140805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 CHARLOTTE PL",
"city": "HARTSDALE",
"state": "NY",
"postal_code": "105302602",
"telephone_number": "914-625-4568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1879 MADISON AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100352709",
"telephone_number": "212-423-4262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTONIO",
"first_name": "EDUARDO",
"middle_name": "SANTIAGO",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NY",
"license": "0004771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.