MRS. NICOLE MARIE ANTENUCCI (P.A.) – Physician Assistant, NPI 1972739852
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
356 PHYSICIAN ASSISTANT in HI
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Provider Addresses for MRS. NICOLE MARIE ANTENUCCI (P.A.)
520, Lunalilo Home Road, Marina East, Hawaii Kai, Mariner's Cove, Honolulu, Honolulu County, Hawaii, 96825, United States
UNIT 7327
HONOLULU, HI 968251700
Phone: (814) 590-5495
Type: Mailing
1, Jarrett White Road, Moanalua Gardens, Honolulu, Honolulu County, Hawaii, 96859, United States
TAMC
TRIPLER ARMY MEDICAL CENTER, HI 968595001
Phone: (808) 433-7699
Type: Location
3 SHIRCLIFF WAY
STE 714
JACKSONVILLE, FL 322044786
Phone: (814) 590-5495
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 24 Open Payments records for all available years, with a total value of $1,530.
Total Amount is formed as General ($1,530) + Research ($0) + Ownership ($0) = $1,530.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($1,019).
Total Amount
$1,530
General + Research + Ownership
Payments
24
Total payment records
General Amount
$1,530
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Intuitive Surgical, Inc. | $1,019 |
| ImmunoGen, Inc. | $115 |
| GlaxoSmithKline, LLC. | $93 |
| Merck Sharp & Dohme LLC | $89 |
| ABBVIE INC. | $41 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-06-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170621002927 | I | Physician Assistant | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 58571 | Removal of uterus, tubes, and/or ovaries through abdomen using an endoscope, 250.0 g or less | 12 | 12 | $0 |
Insurance plans in this area (ZIP 96825)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| Physician Assistant | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| Family Practice | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| Family Practice | FL |
Reviews
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