NPIMap

Individual provider Active NPI

Michael Louis Antolini

  • Family Medicine Physician
  • Fayetteville, WV
National Provider Identifier
1851659387
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2767 Issued in WV
Practice address
5493 Maple LN
Fayetteville, WV 25840-6872
Phone
(304) 469-3334
Fax
(304) 465-1735
NPI assigned
May 3, 2012
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2767 WV Primary

Addresses

Primary practice location

5493 Maple LN
Fayetteville, WV 25840-6872

Mailing address

252 Rural Acres Dr
Beckley, WV 25801-3503
Phone (304) 253-2628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141122000039 WV Practitioner - Family Practice 0941522254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Systems IncGroup PAC ID 6608785795, 36 clinicians

Practice addresses (Care Compare)

252 Rural Acres Dr
Beckley, WV 25801-3503

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.54 of 100Reported as group
Quality
92.57
Promoting interoperability
100
Improvement activities
40
Cost
69.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Systems Inc CurrentSince Sep 13, 2014 Accepting new patients
Community Health Systems, Inc. CurrentSince Sep 13, 2014 Accepting new patients
Hresan Leasing Co., LLC Past Accepting new patients
Saddle Shop Road Operations LLC Past Accepting new patients
106 Tyree Street Operations LLC Past Accepting new patients
Fayette Nursing & Rehabilitation Center LLC Past Accepting new patients

Locations

101 Bill Baker Way
Beckley, WV 25801

252 Rural Acres Dr
Beckley, WV 25801
Phone (304) 252-8551

2157 Ritter Dr
Daniels, WV 25832
Phone (304) 461-0300

5493 Maple Ln
Fayetteville, WV 25840
Phone (304) 461-0068

Interoperability endpoints

  • Direct secure messaging: michael.antolini.1@14333.direct.athenahealth.com
  • Direct secure messaging: michael.antolini@wvafn.hcadirect.net

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hillside CenterHilltop, WV, CCN 515061 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2024
Feb 9, 2025
Ansted CenterAnsted, WV, CCN 515133 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2024
Feb 24, 2025
Hidden Valley CenterOak Hill, WV, CCN 515147 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2024
Mar 23, 2025
Fayetteville Healthcare CenterFayetteville, WV, CCN 515153 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 14, 2023
Apr 8, 2025

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1851659387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 RURAL ACRES DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013503",
            "telephone_number": "304-253-2628",
            "fax_number": "304-252-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5493 MAPLE LN",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258406872",
            "telephone_number": "304-469-3334",
            "fax_number": "304-465-1735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOLINI",
        "first_name": "MICHAEL",
        "middle_name": "LOUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-03",
        "last_updated": "2025-01-09",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "2767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, WV

Sources for this page

Verify at the official NPI Registry.