Michael J Antonini, M.D.
Individual provider Active NPI Surgery Physician · Auburn, CA
NPI 1700924941 · NPPES record last updated Aug 21, 2024
Key facts
- NPI
- 1700924941
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- G84850 (CA)
- Practice address
- 11795 Education St Ste 201
Auburn, CA 95602-2469 - Phone
- (530) 745-0720
- Fax
- (530) 745-0718
- NPI assigned
- Feb 1, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 28
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- Medical College of Wisconsin, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sutter Valley Medical Foundation
Practice addresses (Care Compare)
2800 L St
Sacramento, CA 95816-5616
Hospital & facility affiliations
- Sutter Auburn Faith Hospital
- Sutter Medical Center, Sacramento
- Sutter Roseville Medical Center
- Sierra Nevada Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 28 |
| Mastectomy | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- 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 |
|---|---|---|---|---|
| I20080725000338 | CA | Practitioner - General Surgery | 8325111214 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G84850 | CA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Valley Medical Foundation | Surgery | Current |
Accepting new patients |
| Sutter Valley Medical Foundation | Current |
Accepting new patients | |
| Sutter Valley Medical Foundation | Current | Accepting new patients | |
| Sutter Valley Hospitals | Past | Accepting new patients | |
| Community Hospital of San Bernardino | Past | Accepting new patients | |
| Sutter North Medical Foundation | Past | Accepting new patients |
Locations
11795 Education St
Ste 201
Auburn, CA 95602
Phone (530) 745-0720
2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850
Interoperability endpoints
- mantonini17918@hisp.ehr.sutterhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | G84850 | CA | Yes |
Addresses
Primary practice location
11795 Education St Ste 201
Auburn, CA 95602-2469
Mailing address
PO Box 255228
Sacramento, CA 95865-5228
Phone (191) 670-8803
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0091920 | Medicaid | CA |
Other providers in Auburn, CA
- Taylor Anderson
- Maria Emma Andino
- Yazmin Andresen
- Justin Gabriel Mejia Angeles
- Amanda J Anguish
- Ellen Masako Aoki
- Daniel Apgar
- Leslie Arango
- Valeska Armisen
- Umaima Shabbir Arsiwala
All providers in Auburn, CA · Surgery Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2024. 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.