Individual provider Active NPI

Dominic A Antico, MD

  • Diagnostic Ultrasound Physician
  • Indiana, PA
National Provider Identifier
1912958075
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
License
MD013200E Issued in PA
Practice address
Hospital Road
Indiana, PA 15701
Phone
(724) 357-7125
Fax
(724) 357-7487
NPI assigned
May 13, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X MD013200E PA
Nuclear Radiology Physician 2085N0904X MD013200E PA
Pediatric Radiology Physician 2085P0229X MD013200E PA
Diagnostic Radiology Physician 2085R0202X MD013200E PA
Vascular & Interventional Radiology Physician 2085R0204X MD013200E PA
Diagnostic Ultrasound Physician 2085U0001X MD013200E PA Primary

Addresses

Primary practice location

Hospital Road
Indiana, PA 15701

Mailing address

7 Acee Drive
Natrona Heights, PA 15065
Phone (800) 223-5544

Other identifiers 2

IdentifierTypeStateIssuer
0006874530007MedicaidPA
155732OtherPAHIGHMARK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD013200EPAMDDiagnostic Ultrasound Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiologic Consultants, LTD Diagnostic Radiology Past Accepting new patients
Unity Pathology Associates Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1912958075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ACEE DRIVE",
            "city": "NATRONA HEIGHTS",
            "state": "PA",
            "postal_code": "15065",
            "telephone_number": "800-223-5544",
            "fax_number": "724-294-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL ROAD",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "15701",
            "telephone_number": "724-357-7125",
            "fax_number": "724-357-7487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTICO",
        "first_name": "DOMINIC",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "PA",
            "license": "MD013200E",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "PA",
            "license": "MD013200E",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "PA",
            "license": "MD013200E",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD013200E",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MD013200E",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "PA",
            "license": "MD013200E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006874530007",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "155732",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.