Michael Antoniolli, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4301101315 Issued in MI

Practice address

4201 Saint Antoine St
6G Uhc
Detroit, MI 48201-2153

Phone

(313) 993-2530

NPI assigned

Aug 1, 2012

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

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Emergency Medicine

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dupage Emergency Physicians Convenient Care LLCGroup PAC ID 6608840046, 30 clinicians

Dupage Emergency Physicians LTDGroup PAC ID 6507854288, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Dupage Emergency Physicians Convenient Care LLC

  • Emergency Medicine Physician
  • Lemont, IL
  • NPI 1922000363

  Emergency Medicine, IL

  Medicare reassignment Care Compare group NPD
• Dupage Emergency Physicians LTD

  • Emergency Medicine Physician
  • Downers Grove, IL
  • NPI 1255323481

  IL

  Medicare reassignment Care Compare group

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

• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Downers Grove, IL
  • NPI 1578670543

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1780930248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "6G UHC",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "6G UHC",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-993-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIOLLI",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-01",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301101315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saul Joseph Anthony, LLBSW
• Shannon Antishin, DO
• Zakiya Antoine, D.O.
• Michael Charles Anton, PSY.D.
• Timothy John Antonelli, R.PH.
• Shelley Antonucci, NURSE PRACTITIONER
• Kunjamma Antony
• Leo H Antrassian, PA-C
• Shir Nikko Anuddin
• Nagaspurthy Reddy Anugu, M.D

• All providers in Detroit, MI
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.