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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.

NICOLAS ANTONELLIS
NPI 1932095346
Physician Assistant in Providence, RI

Active since June 13, 2025PECOS Enrolled
593 EDDY ST, PROVIDENCE, RI 02903(401) 444-2734(401) 606-8555 Get Directions Write a Review

NPPES record last updated: October 1, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 1, 2026, Jun 13, 2025 (2 updates tracked since 2025).

About Nicolas Antonellis NPPES

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

NICOLAS ANTONELLIS (NPI 1932095346) is an individual physician assistant in Providence, Rhode Island, licensed in Rhode Island (PA01983) and active in the NPI registry since June 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1932095346
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameNICOLAS ANTONELLIS
Location Address593 EDDY STProvidence, RI 02903-4923
Mailing Address15 La Salle SqProvidence, RI 02903-1814 · (401) 444-6779 · Fax (401) 444-6912
Phone(401) 444-2734
Fax(401) 606-8555
Sole ProprietorNo
Enumeration DateJune 13, 2025
Last NPPES UpdateOctober 1, 20262 updates tracked since enumeration
NPPES CertifiedOctober 1, 2026
✔ NPI 1932095346 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 RI · PA01983
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.
593 EDDY ST, Providence, RI 02903
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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 (PECOS)

Nicolas Antonellis 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 02903 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
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$72.93 typical visit price
range $18.92 – $144.38
Typical copayment $18.23 (range $4.73 – $36.09)
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 20

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

DR. KEITH-AUSTIN SCARFO D.O.
Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Providence County (401) 444-3777
AILEEN HSUEH
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-8450
RHODE ISLAND HOSPITAL
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Providence County (401) 444-7585
DR. GA HIE NAM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-5057
EUGENIE ATALLAH
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-2645
BRET CAULFIELD
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4000
JUNG HO GONG
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 793-2695
FANNY HUANG MD
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4741

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 Nicolas Antonellis's NPI number?

The NPI number for Nicolas Antonellis is 1932095346. It was assigned to this individual provider in the NPPES registry on June 13, 2025.

Where is Nicolas Antonellis located?

Nicolas Antonellis practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 444-2734.

What is Nicolas Antonellis's specialty?

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

Is Nicolas Antonellis enrolled in Medicare?

Yes. Nicolas Antonellis is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicolas Antonellis was last updated on October 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.