Individual provider Active NPI

David Eric Antman, MD

  • Emergency Medicine Physician
  • Ann Arbor, MI
National Provider Identifier
1942324959
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
048695 Issued in CT
Practice address
1500 E Medical Center Dr
B1-380 TC
Ann Arbor, MI 48109-0999
Phone
(734) 763-7919
Fax
(734) 763-9298
NPI assigned
Mar 16, 2007
Last updated
Jun 17, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 048695 CT Primary

Addresses

Primary practice location

1500 E Medical Center Dr
B1-380 TC
Ann Arbor, MI 48109-0999

Mailing address

633 N 5TH Ave
Ann Arbor, MI 48104-1020
Phone (585) 317-8243

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100804000298 CT Practitioner - Emergency Medicine 4587797030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Columbia University College of Physicians and Surgeons, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middlesex HospitalGroup PAC ID 5092611731, 231 clinicians

Practice addresses (Care Compare)

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
048695CTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital CurrentSince Jul 12, 2010 Accepting new patients
Connecticut Pathology Group PC Current Accepting new patients
Middlesex Hospital CurrentSince Jul 12, 2010 Accepting new patients

Locations

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878

Interoperability endpoints

  • Direct secure messaging: dantman17994@middlesexhealthprd.direct-ci.com

Organizations & group practices 3

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1942324959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 N 5TH AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481041020",
            "telephone_number": "585-317-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "address_2": "B1-380 TC",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481090999",
            "telephone_number": "734-763-7919",
            "fax_number": "734-763-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTMAN",
        "first_name": "DAVID",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "048695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.