Canio Thomas Marcantonio, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

103584 Issued in NC

Practice address

2915 Lyndhurst Ave
Winston Salem, NC 27103-4005

Phone

(336) 765-5221

Fax

(336) 765-0430

NPI assigned

Mar 22, 2006

Sex

Male

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Medical Park Hospital Hospital, Winston-Salem, NC, CCN 340148
• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group
• Novant Health Medical Group, LLC

  • Pulmonary Disease Physician
  • Monroe, NC
  • NPI 1033664933
  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  NPD (past)

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

• Forsyth Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation
• Medical Park Hospital LLC

  • General Acute Care Hospital
  • Winston-Salem, NC
  • NPI 1538111828
  Care Compare affiliation

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1730148263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 LYNDHURST AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034005",
            "telephone_number": "336-765-5221",
            "fax_number": "336-765-0430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Kimel Park Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "27103",
            "country_code": "US",
            "telephone_number": "336-245-2100",
            "fax_number": "336-768-7782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCANTONIO",
        "first_name": "CANIO",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8101544",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmarcantonio19905@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "140 Kimel Park Dr Ste 100",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tychanna Mapp
• Heather Danielle Maradiaga, PA-C
• Ahmed Maraey, M.D.
• Hima Maramreddy, M.D.
• Robert M Marble, MD
• Sheila Louise Marceron, PNP
• Elizabeth Wood Marcet, MD
• Paul Marcet
• Bryan Marchant
• Michael Marchese

• Physician Assistant in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.