Individual provider Active NPI

Robert Antoniou, M.D.

  • Anesthesiology Physician
  • Brighton, MA
National Provider Identifier
1649567702
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
248854 Issued in 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
Last updated
Jul 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 248854 MA Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150724010279 NY Practitioner - Pain ManagementPractitioner - Anesthesiology 4082927785 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Medical Wellness PCGroup PAC ID 6709128697, 22 clinicians

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

ProcedureNumber of procedures
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
248854MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emusc, LLC CurrentSince May 23, 2017 Accepting new patients
Emusc, LLC Anesthesiology CurrentSince May 23, 2017 Accepting new patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Aug 1, 2015 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 H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1649567702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 BEACON ST",
            "address_2": "APT 114",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024462092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "address_2": "ST. ELIZABETH'S MED CNTR, CMP-2, #211",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-789-2777",
            "fax_number": "617-254-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIOU",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-08",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "248854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.