Michael Adam Antonis, PA
Individual provider Active NPI Physician Assistant · Sebastian, FL
NPI 1619569738 · NPPES record last updated Feb 9, 2021
Key facts
- NPI
- 1619569738
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA9113950 (FL)
- Practice address
- 8701 N US Highway 1
Sebastian, FL 32958-7524 - Phone
- (772) 228-8480
- NPI assigned
- Feb 9, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211018002646 | FL | Practitioner - Physician Assistant | 6204234586 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9113950 | FL | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9113950 | FL | Yes |
Addresses
Primary practice location
8701 N US Highway 1
Sebastian, FL 32958-7524
Mailing address
8701 N US Highway 1
Sebastian, FL 32958-7524
Other providers in Sebastian, FL
- Connie Yvonne Allgood
- Amberly Paradoa DPM PA
- Amedisys South Florida, L.L.C.
- Sherri Madrid Anderson
- Annapurna Institute, Inc.
- Arthur Argenio
- Katherine Smyth Atwood
- Awareness Counseling Center of the Indian River Inc
- Priscilla M. Bailey
- Hilary Jayne Bainbridge
All providers in Sebastian, FL · Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.