NPIMap

Individual provider Active NPI

Anton Constantin Vasiliu, MD

  • Internal Medicine Physician
  • Centerville, OH
National Provider Identifier
1558356170
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35064984V Issued in OH
Practice address
6611 Clyo Rd
Suite E
Centerville, OH 45459-2786
Phone
(937) 208-8283
Fax
(937) 208-8293
NPI assigned
Sep 20, 2005
Last updated
Aug 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35064984V OH Primary

Addresses

Primary practice location

6611 Clyo Rd
Suite E
Centerville, OH 45459-2786

Mailing address

6611 Clyo Rd
Suite E
Centerville, OH 45459-2786
Phone (937) 208-8283

Other identifiers 1

IdentifierTypeStateIssuer
0930309MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110427000141 OH Practitioner - Internal MedicinePractitioner - Geriatric Medicine 4284628793 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Medical Primary Care, IncGroup PAC ID 0840284345, 8 clinicians
Valley Medical LTC IncGroup PAC ID 8820505258, 7 clinicians

Practice addresses (Care Compare)

6611 Clyo Rd
Suite E
Centerville, OH 45459-2785
Phone (937) 208-8282

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35064984VOHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical LTC Inc CurrentSince Jul 20, 2025 Accepting new patients
Valley Medical Primary Care, Inc CurrentSince Sep 1, 2002 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Mvhe Inc Internal Medicine Past Accepting new patients
St Leonard Past Accepting new patients

Locations

6611 Clyo Rd
Ste E
Dayton, OH 45459
Phone (937) 208-8282

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St LeonardCenterville, OH, CCN 365714 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 27, 2024
Aug 27, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • St Leonard
    • Nursing Facility/Intermediate Care Facility
    • Centerville, OH
    • NPI 1851387047

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1558356170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6611 CLYO RD",
            "address_2": "SUITE E",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592786",
            "telephone_number": "937-208-8283",
            "fax_number": "937-208-8293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6611 CLYO RD",
            "address_2": "SUITE E",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592786",
            "telephone_number": "937-208-8283",
            "fax_number": "937-208-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASILIU",
        "first_name": "ANTON",
        "middle_name": "CONSTANTIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35064984V",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0930309",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

Verify at the official NPI Registry.