Lena Antoski, MS, RN, AGPCNP-BC
Individual provider Active NPI Nurse Practitioner · Macomb, MI
NPI 1861817348 · NPPES record last updated Feb 20, 2014
Key facts
- NPI
- 1861817348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4704253119 (MI)
- Practice address
- 56491 Broadmoor LN
Macomb, MI 48042-1193 - Phone
- (596) 321-2240
- NPI assigned
- Feb 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Charles G Kissel DPM PC
Practice addresses (Care Compare)
29433 Ryan Rd
Warren, MI 48092-2203
Phone (586) 574-0500
Hospital & facility affiliations
- Beaumont Hospital Royal Oak
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140919001504 | MI | Practitioner - Nurse Practitioner | 2860611001 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704253119 | MI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michel Hanna MD PC | Current |
Accepting new patients | |
| Charles G Kissel DPM PC | Current |
Accepting new patients |
Locations
1701 South Blvd E
Ste 190
Rochester Hills, MI 48307
Phone (248) 289-1509
43200 Dequindre Rd
Ste 102
Sterling Heights, MI 48314
Phone (586) 731-8200
29433 Ryan Rd
Warren, MI 48092
Phone (586) 574-0500
Interoperability endpoints
- lantoski285207@direct.hfhs.org
- lena.antoski@cgkdp-mi.direct.office.nextgen.com
- https://fhir.meditouchehr.com/api/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704253119 | MI | Yes |
Addresses
Primary practice location
56491 Broadmoor LN
Macomb, MI 48042-1193
Mailing address
56491 Broadmoor LN
Macomb, MI 48042-1193
Phone (596) 321-2240
Other providers in Macomb, MI
- Angelica Aman
- Paul John Andary Jr.
- Angelic Homecare, Inc.
- Chiragbhai Narendrabhai Aniyali
- Anna M. Hickey, Inc.
- Apollo Pharmacy of Shelby, Inc
- Emmanuel Appah
- Amy Louise Appugliese
- Haya Aranki-Michael
- Armiel Transport
All providers in Macomb, MI · Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.