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ANTONETTE MALIWAT ANTONIO N.P
NPI 1740618420
Nurse Practitioner in San Diego, CA

Active since October 16, 2013PECOS EnrolledAccepts Medicare Assignment
3851 ROSECRANS STREET, SUITE 128, SAN DIEGO, CA 92110(619) 692-8890 Get Directions Write a Review

NPPES record last updated: December 31, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Antonette Maliwat Antonio N.p NPPES

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

ANTONETTE MALIWAT ANTONIO N.P (NPI 1740618420) is an individual nurse practitioner in San Diego, California, licensed in California (23320) and active in the NPI registry since October 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1740618420
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameANTONETTE MALIWAT ANTONIOCredential: N.P
Location Address3851 ROSECRANS STREET, SUITE 128San Diego, CA 92110
Mailing Address5054 Lambert LaneSan Diego, CA 92115 · (619) 829-5497
Phone(619) 692-8890
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateOctober 16, 2013
Last NPPES UpdateDecember 31, 2015
✔ NPI 1740618420 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CA · 23320
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedRegistered NurseTaxonomy 163W00000X · License 753737 (CA)
3851 ROSECRANS STREET, SUITE 128, San Diego, CA 92110
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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

Antonette Maliwat Antonio N.p 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 ID7416477781
PECOS Enrollment IDI20250218001302
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 92110 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
Most-billed visit code 99214
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 Antonette Antonio's NPI number?

The NPI number for Antonette Antonio is 1740618420. It was assigned to this individual provider in the NPPES registry on October 16, 2013.

Where is Antonette Antonio located?

Antonette Antonio practices at 3851 Rosecrans Street, Suite 128, San Diego, CA 92110. The listed phone number is (619) 692-8890.

What is Antonette Antonio's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Antonette Antonio enrolled in Medicare?

Yes. Antonette Antonio 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 Antonette Antonio was last updated on December 31, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.