Individual provider Active NPI

Antonio P. Giannelli, P.A.C.

  • Physician Assistant
  • Lansing, MI
National Provider Identifier
1841369642
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601001053 Issued in MI
Practice address
4052 Legacy Pkwy
Suite 200
Lansing, MI 48911-4285
Phone
(517) 272-9700
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1821562 MI
Physician Assistant 363A00000X 5601001053 MI Primary

Addresses

Primary practice location

4052 Legacy Pkwy
Suite 200
Lansing, MI 48911-4285

Mailing address

4052 Legacy Pkwy
Suite 200
Lansing, MI 48911-4285
Phone (517) 272-9700

Other identifiers 3

IdentifierTypeStateIssuer
1821562OtherMILICENSE
1750472734OtherMIGROUP NPI NUMBER
TI035364OtherMISUPERVISOR IGNACZAK

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20070612000664 MI Practitioner - Physician Assistant 9436257631 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1821562MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lansing Rheumatology PLLC Past Accepting new patients
Beals Institute PC PastSince Mar 30, 2006 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: antonio.giannelli.p1@direct.glcor.nextgenshare.com
  • FHIR API: https://api.platform.athenahealth.com/14640/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1841369642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4052 LEGACY PKWY",
            "address_2": "SUITE 200",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114285",
            "telephone_number": "517-272-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4052 LEGACY PKWY",
            "address_2": "SUITE 200",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114285",
            "telephone_number": "517-272-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIANNELLI",
        "first_name": "ANTONIO",
        "middle_name": "P.",
        "name_prefix": "Mr.",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "1821562",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601001053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1821562",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1750472734",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERVISOR IGNACZAK",
            "identifier": "TI035364",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.