Fides D Antonio, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95015546 Issued in CA

Practice address

130 La Casa Via Ste 108
Walnut Creek, CA 94598-3036

Phone

(877) 448-3627

Fax

(866) 507-1164

NPI assigned

Dec 11, 2020

Last updated

Dec 11, 2020By the provider in NPPES

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 CA

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mark H Mazur MD and Barry Statner MD a Professional CorporationGroup PAC ID 1254373806, 15 clinicians

Metro Infectious Disease Consultants LLCGroup PAC ID 3072425784, 386 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fides.antonio.1@15542.direct.athenahealth.com

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.

• Mark H Mazur MD & Barry Statner MD a Professional Corporation

  • Infectious Disease Physician
  • Thousand Oaks, CA
  • NPI 1376631341
  Medicare reassignment Care Compare group NPD
• Metro Infectious Disease Consultants, LLC

  dba Midc, LLC

  • Infectious Disease Physician
  • Burr Ridge, IL
  • NPI 1235125717

  CA, Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Metro Infectious Disease Consultants LLC

  dba Midc

  • Infectious Disease Physician
  • Jonesboro, GA
  • NPI 1770307191
  NPD
• Metro Infectious Disease Consultants, LLC

  • Infectious Disease Physician
  • Plymouth, MI
  • NPI 1841530250
  NPD (past)
• Metro Infusion Center PLLC

  • Infectious Disease Physician
  • Temple Terrace, FL
  • NPI 1659862860
  NPD (past)

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1609462845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MCCLINTOCK DR STE 202",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270872",
            "telephone_number": "630-655-6748",
            "fax_number": "630-734-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LA CASA VIA STE 108",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983036",
            "telephone_number": "877-448-3627",
            "fax_number": "866-507-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIO",
        "first_name": "FIDES",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95015546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bret David Annoni, D.D.S.
• Afshin A Anoushiravani
• Anthony N. Demeo, MD, Inc.
• Maria Antikadjian, LFMT
• Ariana Teresa Antonio, PT, DPT, SCS
• Thea Antonio
• Jasmi Anuganti
• Dulce Sumpo Anunciacion, M.D.
• Ana Isabel Aparicio Soriano
• Apex Recovery and Wellness, a Professional Corp.

• Nurse Practitioner in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.