Nataliya Antonova, MD
Individual provider Active NPI Ophthalmology Physician · Wantagh, NY
NPI 1902300296 · NPPES record last updated Jun 11, 2024
Key facts
- NPI
- 1902300296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ophthalmology Physician 207W00000X
- License
- 036.159267 (IL)
- Practice address
- 2185 Wantagh Ave
Wantagh, NY 11793-3917 - Phone
- (516) 785-3900
- NPI assigned
- Mar 21, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Ophthalmology
- Education
- State University of New York Downstate Medical Center, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Connecticut Eye Consultants PC
Practice addresses (Care Compare)
69 Sand Pit Rd
Suite 101
Danbury, CT 06810-4004
Phone (203) 791-2020
Hospital & facility affiliations
- Danbury Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 117 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240730002386 | CT | Practitioner - Ophthalmology | 8527303478 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.159267 | IL | MD | Ophthalmology Physician |
| 77419 | CT | MD | Cornea and External Diseases Specialist Physician |
| 322098-01 | NY | MD | Cornea and External Diseases Specialist Physician |
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connecticut Eye Consultants, PC | Ophthalmology | Current |
Accepting new patients |
| Connecticut Eye Consultants, PC | Ophthalmology | Current |
Accepting new patients |
Locations
69 Sand Pit Rd
Danbury, CT 06810
Phone (203) 748-2551
69 Sand Pit Rd
Ste 101
Danbury, CT 06810
Phone (203) 791-2020
120 Park Lane Rd
Ste B203
New Milford, CT 06776
Phone (203) 791-2020
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 036.159267 | IL | Yes |
| Cornea and External Diseases Specialist Physician | 207WX0120X | 322098-01 | NY | |
| Cornea and External Diseases Specialist Physician | 207WX0120X | 77419 | CT |
Addresses
Primary practice location
2185 Wantagh Ave
Wantagh, NY 11793-3917
Mailing address
2185 Wantagh Ave
Wantagh, NY 11793-3917
Other practice location 1
69 Sand Pit Rd
Danbury, CT 06810-4004
Phone (203) 791-2020
Other providers in Wantagh, NY
- Joseph Ambrosio
- Stephanie S. Anderson
- Adrianna Angiuli
- Amanda Anselme
- Jonathan Richard Anson
- David M Arbesfeld
- Jane Finan Arena
- Victor Arena
- Lauren Argila
- Priyanka Arora
All providers in Wantagh, NY · Ophthalmology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2024. 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.