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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MICHAEL CONSTANTINE ANTONELLIS
NPI 1548930936
Physician Assistant in Bridgeport, CT

Active since September 16, 2021PECOS Enrolled
2800 MAIN STREET DEPT OF SURGERY, BRIDGEPORT, CT 06606(475) 210-6512 Get Directions Write a Review

NPPES record last updated: July 20, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 20, 2026, Sep 18, 2024, Sep 16, 2021 (3 updates tracked since 2021).

About Michael Constantine Antonellis NPPES

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

MICHAEL CONSTANTINE ANTONELLIS (NPI 1548930936) is an individual physician assistant in Bridgeport, Connecticut, licensed in Connecticut (6627) and active in the NPI registry since September 2021. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1548930936
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMICHAEL CONSTANTINE ANTONELLIS
Location Address2800 MAIN STREET DEPT OF SURGERYBridgeport, CT 06606
Mailing Address1290 Silas Deane HwyWethersfield, CT 06109-4337 · (203) 909-4171
Phone(475) 210-6512
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateSeptember 16, 2021
Last NPPES UpdateJuly 20, 20263 updates tracked since enumeration
NPPES CertifiedJuly 20, 2026
✔ NPI 1548930936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CT · 6627
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2800 MAIN STREET DEPT OF SURGERY, Bridgeport, CT 06606
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Secondary Practice Locations 2

Location 155 Fruit StBoston, MA 02114-2621 · Phone (617) 724-4100
Location 21 Hospital PlzStamford, CT 06902-3602 · Phone (203) 276-1000

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael Constantine Antonellis is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052702867
PECOS Enrollment IDI20240926001299
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 06606 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
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.

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 Michael Antonellis's NPI number?

The NPI number for Michael Antonellis is 1548930936. It was assigned to this individual provider in the NPPES registry on September 16, 2021.

Where is Michael Antonellis located?

Michael Antonellis practices at 2800 Main Street Dept Of Surgery, Bridgeport, CT 06606. The listed phone number is (475) 210-6512.

What is Michael Antonellis's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Michael Antonellis enrolled in Medicare?

Yes. Michael Antonellis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Michael Antonellis was last updated on July 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 27 days 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.