Lisa F Antonelli, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

72272 Issued in MA

Practice address

2100 Dorchester Avenue
SMG - Carney Hospital
Dorchester, MA 02124

Phone

(617) 296-4000

Fax

(617) 474-3860

NPI assigned

Oct 21, 2005

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Lisa Antonelli MD

  • Cardiovascular Disease Physician
  • Quincy, MA
  • NPI 1235129222
  NPD (past) Authorized official
• Pocatello Health Services, LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1689802852
  NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD (past)

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1639169618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVENUE",
            "address_2": "SMG - CARNEY HOSPITAL",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "02124",
            "telephone_number": "617-296-4000",
            "fax_number": "617-474-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVENUE",
            "address_2": "SMG - CARNEY HOSPITAL",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "02124",
            "telephone_number": "617-296-4000",
            "fax_number": "617-474-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONELLI",
        "first_name": "LISA",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "72272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3060284",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J09499",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "60264",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "755370",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chioma Veronica Aniagboso
• Anns Rest Home Inc.
• Kemberly Anthony-Esperience, LCSW
• Berthnell Rebecca Antoine
• Dominique Dujuan Antoine, NP
• Hannah Antonellis
• Apex Pharmacy Solutions, Inc.
• Apollo Dental Ass.
• Guy Apollon, LCSW
• Jeanette Apperwhite

• Cardiovascular Disease Physician in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Cardiovascular Disease Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.