Justina Aguirre Antonio, PA – Physician Assistant

Key facts

NPI: 1881733103
Entity type: Individual (NPI type 1)
Primary specialty: Physician Assistant 363A00000X
License: 001391 (CT)
Practice address: 80 Mill River St
Stamford, CT 06902-3733
Phone: (203) 348-7410
NPI assigned: Feb 5, 2007
Sex: Female
Sole proprietor: No

Organizations & group practices 5

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.

Montefiore Medical Center Anesthesiology Physician · Bronx, NY · NPI 1063525152

Medicare reassignment NPD (past) NY
Montefiore Medical Center Community/Retail Pharmacy · Bronx, NY · NPI 1194183715

NPD
Montefiore Medical Center Family Medicine Physician · New York, NY · NPI 1760288278

NPD
Heart Physicians, P.C. Specialist · Stamford, CT · NPI 1497727580

NPD (past)
Stamford Health Medical Group Inc General Practice Physician · Stamford, CT · NPI 1154633980

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NY
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
I20110509000260	NY	Practitioner - Physician Assistant	1759484876	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Physician Assistant

State licenses

License	State	Type	Specialty
007274	NY	MD	Occupational Therapy Assistant
007274-1	NY	MD	Physician Assistant

Practice roles (5 of 9)

Organization	Status	New patients
Montefiore Medical Center	Current since Feb 10, 2011	Accepting new patients
Montefiore Medical Center	Current since Feb 10, 2011	Accepting new patients
Montefiore Medical Center	Past	Accepting new patients
Stamford Health Medical Group Inc	Past	Accepting new patients
Heart Physicians, P.C.	Past	Accepting new patients

Locations

80 Mill River St
Stamford, CT 06902
Phone (203) 327-1080

80 Mill River St
Ste 1300
Stamford, CT 06902
Phone (203) 348-7410

111 E 210th St
Bronx, NY 10467

1250 Waters Pl
Bronx, NY 10461
Phone (718) 409-9444

Networks

Healthfirst Medicare Network H3359
Healthfirst Medicare Network H5989
Healthfirst Medicare Network H1722
Healthfirst Medicare Network H9678

Interoperability endpoints

FHIR API: https://fhir4.healow.com/fhir/r4/ABCIBA

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physician Assistant	363A00000X	001391	CT	Yes
Physician Assistant	363A00000X	007274-1	NY

Addresses

Primary practice location

80 Mill River St
Stamford, CT 06902-3733

Mailing address

10 Franklin Ave
Unit 1C
White Plains, NY 10601-3848
Phone (914) 686-5138

Other providers in Stamford, CT

All providers in Stamford, CT · Physician Assistant in Connecticut

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2010. 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).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.