Active NPI
Tatyana Antonevich, MD
- Pulmonary Disease Physician
- Williamsville, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- ME90499
- Practice address
- 100 College Pkwy
Ste 110
Williamsville, NY 14221-6885 - Phone
- (716) 631-8863
- Fax
- (716) 631-1265
- NPI assigned
- Sep 27, 2005
- Last updated
- Sep 21, 2026
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | ME90499 | FL | Primary |
Addresses
Primary practice location
100 College Pkwy
Ste 110
Williamsville, NY 14221-6885
Mailing address
199 Park Club LN Ste 500
Williamsville, NY 14221-5269
Phone (716) 845-1300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03465381 | Medicaid | NY |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Charles T. Sitrin Health Care Center Inc
Practice addresses (Care Compare)
2050 Tilden Ave
New Hartford, NY 13413-3613
Phone (315) 797-3114
4 Ellinwood Dr
New Hartford, NY 13413-1110
Phone (315) 624-5960
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME90499 | FL | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ia Health Medicine PLLC | Pulmonary Disease | Current | Accepting new patients |
| Costello Eye Physicians & Surgeons, PLLC | Current | Accepting new patients | |
| Pulmonary Group of Western New York, LLP | Pulmonary Disease | Past | Accepting new patients |
| Rpci Oncology PC | Pulmonary Disease | Past | Accepting new patients |
Locations
2 Ellinwood Dr
New Hartford, NY 13413
Phone (315) 507-5081
4 Ellinwood Dr
New Hartford, NY 13413
Phone (315) 624-5960
131 Main St
Ste 201
Oneida, NY 13421
Phone (315) 363-1110
Interoperability endpoints
- https://app.meldrx.com/api/fhir/Freedom_CEP
- tatyanaantonevichmd@iahealth.medentdirect.com
Organizations & group practices 4
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.
-
- Interventional Pain Medicine Physician
- New Hartford, NY
- NPI 1376433482
Pulmonary Disease
-
- Ophthalmology Physician
- Oneida, NY
- NPI 1699785832
-
- Pulmonary Disease Physician
- Williamsville, NY
- NPI 1629131180
-
dba Breast Care of Western New York
- Hematology & Oncology Physician
- Williamsville, NY
- NPI 1952703985
Pulmonary Disease
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Delta Medical
- Internal Medicine Physician
- Rome, NY
- NPI 1700121894
Hospital
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Rome, NY
- NPI 1306807193
Hospital
-
dba Regional Wound Care Center
- Clinic/Center
- Rome, NY
- NPI 1356689004
Hospital
-
dba Camden Family Care
- Primary Care Clinic/Center
- Camden, NY
- NPI 1891113965
Hospital
-
- General Acute Care Hospital
- Rome, NY
- NPI 1376546440
-
dba Chestnut Commons
- Physical Therapy Clinic/Center
- Rome, NY
- NPI 1851489330
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789948800000",
"number": "1528054368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "199 PARK CLUB LN STE 500",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142215269",
"telephone_number": "716-845-1300",
"fax_number": "716-322-3372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 COLLEGE PKWY",
"address_2": "STE 110",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142216885",
"telephone_number": "716-631-8863",
"fax_number": "716-631-1265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTONEVICH",
"first_name": "TATYANA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-27",
"last_updated": "2026-09-21",
"certification_date": "2025-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "FL",
"license": "ME90499",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03465381",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williamsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; 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.