JOHN VITO ANTONUCCI (NPI# 1619181369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619181369 |
| Entity Type | Individual |
| Full Name | JOHN VITO ANTONUCCI |
| Credential | M.D. |
| Practice Address |
70 Fulton St Pontiac MI 48341-2755 |
| Mailing Address |
2234 Colonial Blvd Attn: Payer Contracting & Relations Fort Myers FL 33907-1412 |
| Practice Telephone | 2483380300 |
| Practice Fax Number | 2483380663 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2012-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
4301081739 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | HEALTH PLUS OF MICHIGAN THRU OAKLAND PHYSICIANS NETWORK SERVICES | 1046261 | 01 |
| MI | RAILROAD MEDICARE | P01013930 | 01 |
| MI | UNITED HEALTHCARE COMMUNITY PLAN | 200811 | 01 |
| MI | AETNA THRU OAKLAND PHYSICIANS NETWORK SERVICES | 9209246 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225576689 | John Antonucci | Counselor | 2420 Athania Pkwy Ste 102, Metairie, LA 70001-1975 | 2017-02-06 |
| 1508967951 | John Antonucci | Psychiatry & Neurology | 555 Willard Ave, Newington, CT 06111-2631 | 2006-09-26 |
| Street Address |
70 FULTON ST |
| City | PONTIAC |
| State | MI |
| Zip Code | 48341-2755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871553826 | Frank A. Vicini | Radiology | 70 Fulton St, Pontiac, MI 48341-2755 | 2006-03-24 |
| 1073572434 | Larry L Kestin | Radiology | 70 Fulton St, Pontiac, MI 48341-2755 | 2006-03-22 |
| 1164481859 | Mihai I Ghilezan | Radiology | 70 Fulton St, Pontiac, MI 48341-2755 | 2006-03-21 |
| 1710952775 | Michigan Institute for Radiation Oncology/miro Cancer Center | Radiology | 70 Fulton St, Pontiac, MI 48341-2755 | 2006-02-22 |
| 1104890102 | American Oncologic Associates of Michigan, PC | Radiology | 70 Fulton St, Pontiac, MI 48341-2755 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415837 | Brittany Taylor Shandor | Registered Nurse | 32 East, 1200 Telegraph Rd, Pontiac, MI 48341 | 2020-10-22 |
| 1013534999 | Siddharth Chopra | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue Saint Joseph Mercy Oakland Hospit, Medical Education H-23, Pontiac, MI 48341 | 2020-06-26 |
| 1972120962 | Tara Elizabeth Bjorklund | Obstetrics & Gynecology | 44405 Woodward Ave - H23, St. Joseph Mercy Oakland - Gme Office, Pontiac, MI 48341 | 2020-06-25 |
| 1245856145 | Sarah Fatima | Student in an Organized Health Care Education/Training Program | St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-17 |
| 1407471188 | Tyler Schaefer | Emergency Medical Technician, Basic | 32east 1200 N. Telegraph Rd., Pontiac, MI 48341 | 2020-06-09 |
| 1639793581 | Yash Kirankumar Varma | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-05 |
| 1326661687 | Fnu Kavita | Student in an Organized Health Care Education/Training Program | C/o Shelly Casey, St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue Medical Education - H23, Pontiac, MI 48341 | 2020-05-21 |
| 1801452578 | Lolita Curry | Registered Nurse | 32 East 1200 Telegraph, Pontiac, MI 48341 | 2019-05-17 |
| 1619530060 | Priyadarshini Dixit | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, St. Joseph Mercy Oakland Hospita, Pontiac, MI 48341 | 2019-04-20 |
| 1891358370 | Anil Gurpersaud | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave., St. Joseph Mercy Oakland, Pontiac, MI 48341 | 2019-04-19 |
| Find all providers in zip 48341 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114263563 | Michigan Radiation Institute LLC | Radiology | 461 W Huron St, Michigan Radiation Oncology, LLC, Pontiac, MI 48341-1601 | 2012-12-12 |
| 1992899280 | Michigan Oncology Associates Pllc | Radiology | 461 West Huron Street, Pontiac, MI 48341 | 2006-10-03 |
| 1871533323 | Jeffrey D Forman | Radiology | 461 W Huron St, Pontiac, MI 48341-1601 | 2006-06-06 |
| 1871553826 | Frank A. Vicini | Radiology | 70 Fulton St, Pontiac, MI 48341-2755 | 2006-03-24 |
| 1073572434 | Larry L Kestin | Radiology | 70 Fulton St, Pontiac, MI 48341-2755 | 2006-03-22 |
| 1164481859 | Mihai I Ghilezan | Radiology | 70 Fulton St, Pontiac, MI 48341-2755 | 2006-03-21 |
| 1710952775 | Michigan Institute for Radiation Oncology/miro Cancer Center | Radiology | 70 Fulton St, Pontiac, MI 48341-2755 | 2006-02-22 |
| 1104890102 | American Oncologic Associates of Michigan, PC | Radiology | 70 Fulton St, Pontiac, MI 48341-2755 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1811444235 | Gwendolyn Henderson Parker | Radiology | 48165 Liberty Dr, Shelby Twp, MI 48315-4061 | 2016-09-01 |
| 1376097733 | Munson Medical Center | Radiology | 217 S Madison Avenue, Traverse City, MI 49684-2320 | 2016-08-15 |
| 1972985737 | Andrew Thompson | Radiology | 44378 Dequindre Rd Fl 1, Sterling Heights, MI 48314-1003 | 2015-06-29 |
| 1093112799 | Wmro LLC | Radiology | 5950 Metro Way, Wyoming, MI 49519 | 2014-11-24 |
| 1932533692 | Compass Healthcare, Plc | Radiology | 2175 Coolidge Rd, East Lansing, MI 48823-1379 | 2013-08-29 |
| 1083903256 | Omar Hesham Gayar | Radiology | 4100 Beecher Rd Ste A, Flint, MI 48532-3661 | 2011-03-28 |
| 1881906519 | Sanath Kumar | Radiology | 18101 Oakwood Blvd Ste 411, Oakwood Hospital, Dearborn, MI 48124-4089 | 2010-07-10 |
| 1376772574 | Matthew W Packard | Radiology | 145 Michigan St Ne - Suite 2200, Lemmen-holton Cancer Pavilion (radiation/oncology), Grand Rapids, MI 49503 | 2009-07-08 |
| 1053575118 | North Macomb Mrt Center LLC | Radiology | 17900 23 Mile Road, Macomb Twp, MI 48042 | 2008-07-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.