NPIMap

Individual provider Active NPI

Ileana Antoniadis, MD

  • Rheumatology Physician
  • Spring Lake, NJ
National Provider Identifier
1699752634
Registry record updated Mar 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MA 058058 Issued in NJ
Practice address
207 Route 71
Spring Lake, NJ 07762-1875
Phone
(732) 359-7232
Fax
(732) 359-7233
NPI assigned
Dec 30, 2005
Last updated
Mar 25, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X MA 058058 NJ Primary

Addresses

Primary practice location

207 Route 71
Spring Lake, NJ 07762-1875

Mailing address

207 Route 71
Spring Lake, NJ 07762-1875
Phone (732) 359-7232

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050727000162 NJ Practitioner - Internal MedicinePractitioner - Rheumatology 6002844529 Practice locations: Spring Lake Heights, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Rheumatology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

207 State Route 71
Spring Lake, NJ 07762-1875
Phone (732) 359-7232

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
21.37 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
71.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA 058058NJMDRheumatology Physician

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332633600000",
    "number": "1699752634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 ROUTE 71",
            "city": "SPRING LAKE",
            "state": "NJ",
            "postal_code": "077621875",
            "telephone_number": "732-359-7232",
            "fax_number": "732-359-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 ROUTE 71",
            "city": "SPRING LAKE",
            "state": "NJ",
            "postal_code": "077621875",
            "telephone_number": "732-359-7232",
            "fax_number": "732-359-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIADIS",
        "first_name": "ILEANA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2012-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NJ",
            "license": "MA 058058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake, NJ

Sources for this page

Verify at the official NPI Registry.