Anthony Nicholas Miceli, DDS

Primary specialty

DentistTaxonomy code 122300000X

Practice address

20180 Governors Hwy
Ste 104
Olympia Fields, IL 60461

Phone

(708) 747-9777

Fax

(708) 747-1064

NPI assigned

Nov 7, 2007

Sex

Male

Sole proprietor

Yes

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 IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Olympia Fields Family Dental

  • Dental Clinic/Center
  • Olympia Fields, IL
  • NPI 1659921575
  NPD (past)

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1528248598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20180 GOVERNORS HWY",
            "address_2": "STE 104",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "60461",
            "telephone_number": "708-747-9777",
            "fax_number": "708-747-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20180 GOVERNORS HWY",
            "address_2": "STE 104",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "60461",
            "telephone_number": "708-747-9777",
            "fax_number": "708-747-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICELI",
        "first_name": "ANTHONY",
        "middle_name": "NICHOLAS",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-07",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Meier
• Brandon Nicholas Merryman, DO
• Metropolitan Eyecare
• Metropolitan Eyecare Center of Park Forest
• MGG Transportation, Inc
• Midwest Physician Group LTD
• Midwest Physician Group LTD (MPC of Olympia Fields)
• Midwest Physician Group LTD (Midwest Physician Center of Homewood Glenwood)
• Midwest Physician Group LTD
• Midwest Physician Group LTD (MPC-Cardiovascular Institute)

• Dentist in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.