Shelley Antonucci, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704261629 Issued in MI

Practice address

17187 Schaefer Hwy
Detroit, MI 48235-4132

Phone

(313) 960-6605

Fax

(248) 595-8269

NPI assigned

Feb 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nephro-Care MD PLCGroup PAC ID 3971813635, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sinai-Grace Hospital Hospital, Detroit, MI, CCN 230024
• Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
• Harper University Hospital Hospital, Detroit, MI, CCN 230104
• Detroit Receiving Hospital Hospital, Detroit, MI, CCN 230273

Merit-based Incentive Payment System (MIPS)

Final score

84.89 of 100Reported as group

Quality

60.24

Improvement activities

40

Cost

69.29

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Nephro-Care MD PLC

  • Nephrology Physician
  • Detroit, MI
  • NPI 1336510072

  MI

  Medicare reassignment Care Compare group NPD

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

• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253

  Hospital

  Care Compare affiliation
• VHS Detroit Receiving Hospital Inc

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1619289998

  Hospital

  Care Compare affiliation
• VHS Harper-Hutzel Hospital Inc

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1427360700

  Hospital

  Care Compare affiliation
• VHS Sinai-Grace Hospital Inc

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1760794044

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1550188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1497211338",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "355 TYLER ROAD",
            "city": "LASALLE",
            "state": "ONTARIO",
            "postal_code": "N9J3X2"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17187 SCHAEFER HWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482354132",
            "telephone_number": "313-960-6605",
            "fax_number": "248-595-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONUCCI",
        "first_name": "SHELLEY",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-15",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704261629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Antishin, DO
• Zakiya Antoine, D.O.
• Michael Charles Anton, PSY.D.
• Timothy John Antonelli, R.PH.
• Michael Antoniolli, M.D.
• Kunjamma Antony
• Leo H Antrassian, PA-C
• Shir Nikko Anuddin
• Nagaspurthy Reddy Anugu, M.D
• Julie Anumba, RN, MSH

• Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; 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.

Verify at the official NPI Registry.