DR. LISA ANNE ANTONELLI DMD
NPI 1093892390
Dentist - Periodontics in Worcester, MA

Q: What is Lisa Antonelli's NPI number?

The NPI number for Lisa Antonelli is 1093892390. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Q: What is Lisa Antonelli's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Antonelli was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 01, 2006PECOS Enrolled

330 PLANTATION STREET, WORCESTER, MA 01604(508) 753-1911(508) 753-1837 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Lisa Anne Antonelli Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LISA ANNE ANTONELLI DMD (NPI 1093892390) is an individual periodontics provider in Worcester, Massachusetts, licensed in Massachusetts (16204) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093892390

Entity TypeIndividualFemale

Primary Taxonomy1223P0300X

Provider Legal NameDR. LISA ANNE ANTONELLICredential: DMD

Location Address330 PLANTATION STREETWorcester, MA 01604

Mailing Address330 Plantation StreetWorcester, MA 01604 · (508) 753-1911 · Fax (508) 753-1837

Phone(508) 753-1911

Fax(508) 753-1837

Sole ProprietorNo

Enumeration DateNovember 1, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1093892390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in MA · 16204

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

330 PLANTATION STREET, Worcester, MA 01604

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Lisa Anne Antonelli Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01604 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.70 typical visit price

range $58.86 – $177.36

Typical copayment $22.67 (range $14.71 – $44.34)

Most-billed visit code 99203

Established Patient

$73.22 typical visit price

range $19.11 – $144.84

Typical copayment $18.30 (range $4.77 – $36.21)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

UNIVERSITY DENTAL GROUP PC

Dentist (General Practice)

330 PLANTATION STREET
WORCESTER, MA 01604

Worcester County (508) 753-1911

DR. SETA M APELIAN DDS

Dentist (Orthodontics and Dentofacial Orthopedics)

330 PLANTATION STREET
WORCESTER, MA 01604

Worcester County (508) 753-1911

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Antonelli's NPI number?

The NPI number for Lisa Antonelli is 1093892390. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Where is Lisa Antonelli located?

Lisa Antonelli practices at 330 Plantation Street, Worcester, MA 01604. The listed phone number is (508) 753-1911.

What is Lisa Antonelli's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Lisa Antonelli enrolled in Medicare?

Yes. Lisa Antonelli is registered in the Medicare PECOS enrollment system.

What insurance does Lisa Antonelli accept?

Health plans from Anthem Blue Cross and Blue Sheld, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Lisa Antonelli as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Antonelli was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.