Provider Type Icon

LISA MARIE ANTONIO MD NPI 1679951438


NPI Profile

NPI: 1679951438
Provider Name: LISA MARIE ANTONIO, MD
Classification:Family Medicine - 207Q00000X
Entity Type: Individual
Organization: SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM

PECOS Registration: Yes

Address:
222 TONGASS DR
SITKA, AK
ZIP 99835
Get Directions

Phone: (907) 966-8318

Lisa Marie Antonio, MD is a family medicine in Sitka, AK with 6 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Lisa Marie Antonio, MD NPI is 1679951438. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
Graduation Year:2015

The provider's business location address is:

222 TONGASS DR
SITKA, AK
ZIP 99835
Phone: (907) 966-8318
Fax: (907) 966-8606

The NPI 1679951438 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/13/2015 and was last updated on 10/8/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine134059ALASKAYes
2390200000XStudent in an Organized Health Care Education/Training ProgramMED-RES-LIC 52169MONTANANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1134059OTHERALASKASTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/9/2021

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.