Anthony J Scardina, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

08500268 Issued in IL

Practice address

180 South Main Street
Canton, IL 61520-2608

Phone

(309) 647-0201

Fax

(309) 649-6880

NPI assigned

May 20, 2006

Last updated

Apr 13, 2021By 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 6

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Advanced Orthopedics, PC

  • Specialist
  • Peoria, IL
  • NPI 1508924051
  NPD (past)
• Graham Services Corporation

  dba Coleman Clinic

  • Family Medicine Physician
  • Canton, IL
  • NPI 1942315197
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1508810771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 SOUTH MAIN STREET",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202608",
            "telephone_number": "309-647-0201",
            "fax_number": "309-649-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 SOUTH MAIN STREET",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202608",
            "telephone_number": "309-647-0201",
            "fax_number": "309-649-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARDINA",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "08500268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "IL0102",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "7230175",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "970019987",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0850002698",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "021651",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "4281670001",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anthony.scardina@gmgil.eclinicaldirectplus.com",
            "affiliation": "Y",
            "affiliationName": "Graham Hospital Association",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "180 South Main Street",
            "city": "Canton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "615202608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Ann Rockwell
• Jake Ruff, D.P.M.
• Michael J Sammarco, MD
• Amy Sammis, R.D., L.D.N.
• A Kurt Savegnago, MD
• Brian Scheil, RD, LDN
• Tessa R Schifferer, APRN
• Jessica Gail Schoon, LCSW
• Derek Schrodt
• Serenity Point Hospice LLC

• Physician Assistant in Canton, IL
• Providers in Canton, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.