Camille Antonacci, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2022020088 Issued in MO

Practice address

4444 Forest Park Ave
Dept Occupational Therapy, Ste 2210
Saint Louis, MO 63108-2212

Phone

(314) 286-1669

Fax

(314) 627-7219

NPI assigned

Dec 20, 2017

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Washington University

  • Occupational Therapist
  • Saint Louis, MO
  • NPI 1598705923
  Medicare reassignment Care Compare group NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1134169568
  NPD (past)

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1619483153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-286-1669",
            "fax_number": "314-627-7219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 FOREST PARK AVE",
            "address_2": "DEPT OCCUPATIONAL THERAPY, STE 2210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082212",
            "telephone_number": "314-286-1669",
            "fax_number": "314-627-7219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONACCI",
        "first_name": "CAMILLE",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-20",
        "last_updated": "2025-04-15",
        "certification_date": "2024-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2022020088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470138978",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4444 Forest Park Ave",
            "address_2": "Dept Occupational Therapy, Ste 2210",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631082212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jastin L Antisdel, MD
• Antoine Eye Care, LLC
• Michael Antoine, O.D.
• Nichole Antoine, BCBA, LBA
• Lara Buck Antolik, SLP
• Dianna L Antonacci, P.T., M.B.A.
• Laurie Antonetti
• Karth Antony, MD
• Amal F Antoun, M.D.
• Nnamdi Anunobi, MD

• Occupational Therapist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.