OrganizationActive
Oleg Antonov MD PC
NPI 1396186201 · Specialist · Philadelphia, PA
Provider details
- NPI number
- 1396186201
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Oleg Antonov, Owner(215) 111-1111
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11400 Bustleton Ave
Philadelphia, PA 19116
Phone: (215) 111-1111
Street-level locationGet directions
Mailing address
11400 Bustleton Ave
Philadelphia, PA 19116-2815
Other names (DBA / former)
- Doing business as
- 11400 Bustleton Avenue
Registry dates
- Enumerated
- 2013-07-09
- Last updated
- 2013-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.