Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michael Constantine Antonellis

Individual provider Physician Assistant · NPI 1548930936

Michael Constantine Antonellis is a Physician Assistant in Bridgeport, Connecticut. Qualified in 2021, 5 years ago. Practices with Hartford Healthcare Medical Group Specialists PLLC, a 1,537-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
5
Licensed in
CT
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

2800 Main St Dept OF Surgery
Bridgeport, CT 06606
Phone: (475) 210-6512
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1 Hospital Plz, Stamford, CT 06902-3602 — (203) 276-1000
  • 55 Fruit St, Boston, MA 02114-2621 — (617) 724-4100

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 6627 (CT)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1548930936
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 16, 2021
Last updated in NPPESJuly 20, 2026
Certification dateJuly 20, 2026
Mailing address1290 Silas Deane Hwy, Wethersfield, CT 06109-4337

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Hartford Healthcare Medical Group Specialists Pllc — 1537 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Bridgeport