Organization Active NPI

Alfred Antonetti MD and Associates

  • Plastic Surgery Physician
  • Plano, TX
National Provider Identifier
1750476784
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
E1491 Issued in TX
Legal business name
ALFRED ANTONETTI MD AND ASSOCIATES
Practice address
6020 W. Plano Pkwy
Plano, TX 75093-4640
Phone
(469) 429-7558
Fax
(972) 543-2499
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Authorized official

Name
Dr. Alfred R Antonetti, M.D.
Title
Founder
Phone
(469) 429-7558

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X E1491 TX Primary
Surgery of the Hand (Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0105X M3861 TX

Addresses

Primary practice location

6020 W. Plano Pkwy
Plano, TX 75093-4640

Mailing address

6020 W. Plano Pkwy
Plano, TX 75093-4640
Phone (469) 429-7558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070801000542 TX Part B Supplier - Clinic/Group Practice 7113018482 Receives reassigned benefits from 2 practitioners
Practice locations: Plano, TX

National Provider Directory

National Provider Directory

Locations

7777 Forest Ln
Ste C642
Dallas, TX 75230
Phone (214) 942-0885

221 W Colorado Blvd
Ste 400
Dallas, TX 75208
Phone (214) 942-0861

6020 W Plano Pkwy
Plano, TX 75093
Phone (469) 429-7558

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484006400000",
    "number": "1750476784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 W. PLANO PKWY",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934640",
            "telephone_number": "469-429-7558",
            "fax_number": "972-543-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 W. PLANO PKWY",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934640",
            "telephone_number": "469-429-7558",
            "fax_number": "972-543-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALFRED ANTONETTI MD AND ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2017-01-10",
        "status": "A",
        "authorized_official_last_name": "ANTONETTI",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "469-429-7558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "E1491",
            "primary": true
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgery of the Hand",
            "state": "TX",
            "license": "M3861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.