Robert Antoniou, M.D.
Individual provider Active NPI Anesthesiology Physician · Brighton, MA
NPI 1649567702 · NPPES record last updated Jul 10, 2015
Key facts
- NPI
- 1649567702
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 248854 (MA)
- Practice address
- 736 Cambridge St
St. Elizabeth'S Med CNTR, CMP-2, #211
Brighton, MA 02135-2907 - Phone
- (617) 789-2777
- Fax
- (617) 254-6384
- NPI assigned
- Jul 8, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Pain Management
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Community Medical Wellness PC
Practice addresses (Care Compare)
1041 Route 112
Port Jefferson Station, NY 11776-6000
Phone (631) 828-4545
170 E Main St
Babylon, NY 11702-3510
Phone (631) 828-4545
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Laminectomy or laminotomy (partial removal of spine bones) | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150724010279 | NY | Practitioner - Pain Management |
4082927785 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 248854 | MA | MD | Anesthesiology Physician |
Practice roles (4 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North American Partners in Anesthesia LLP | Anesthesiology | Current |
Accepting new patients |
| Emusc, LLC | Anesthesiology | Current |
Accepting new patients |
| Emusc, LLC | Current |
Accepting new patients | |
| Emusc, LLC | Current | Accepting new patients |
Locations
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
8340 Woodhaven Blvd
Glendale, NY 11385
Phone (718) 441-0101
270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308
755 Park Ave
Huntington, NY 11743
Phone (631) 683-4235
1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341
27005 76th Ave
North New Hyde Pk, NY 11040
45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 248854 | MA | Yes |
Addresses
Primary practice location
736 Cambridge St
St. Elizabeth'S Med CNTR, CMP-2, #211
Brighton, MA 02135-2907
Mailing address
1440 Beacon St
Apt 114
Brookline, MA 02446-2092
Other providers in Brighton, MA
- Catia Andrade
- Anna M. Ang
- Rutchele Angelot
- Maria Ansari
- Robert Antonelli
- Sarah Apgar
- Sharon Choon Arakawa
- Arandia Meola LLC
- Jason Arandia
- Ashley Marie Arbuckle
All providers in Brighton, MA · Anesthesiology Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2015. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.