Individual provider Active NPI

Cynthia Marie Antonio, NP-C

  • Family Nurse Practitioner
  • Orange, CA
National Provider Identifier
1962745554
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22233 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-7002
NPI assigned
Apr 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP22233 CA
Family Nurse Practitioner 363LF0000X 22233 CA Primary

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

725 W la Veta Ave Ste 220
Orange, CA 92868-4446
Phone (714) 771-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181019002581 CA Practitioner - Nurse Practitioner 6204189384 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UC Regents Uci Dept of PediatricsGroup PAC ID 5395649222, 8 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7004

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22233CAMDInternal Medicine Physician
NP22233CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Uci Dept of Pediatrics CurrentSince Nov 13, 2023 Accepting new patients
Endocrinology Medical Group of Orange County Inc CurrentSince Sep 17, 2018 Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

200 S Manchester Ave
Ste 300
Orange, CA 92868
Phone (714) 424-9001

101 The City Dr S
Bldg 29
Orange, CA 92868
Phone (714) 456-7005

725 W La Veta Ave
Ste 220
Orange, CA 92868
Phone (714) 771-5700

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1962745554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 W LA VETA AVE STE 220",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684446",
            "telephone_number": "714-771-5700",
            "fax_number": "714-771-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIO",
        "first_name": "CYNTHIA",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-02",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP22233",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.