Individual provider Active NPI

Michael Angeloro, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Walton Beach, FL
National Provider Identifier
1053379917
Registry record updated May 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP3065242 Issued in FL
Practice address
995 Mar Walt Dr
Fort Walton Beach, FL 32547-6758
Phone
(850) 863-7887
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP3065242 FL Primary
Certified Registered Nurse Anesthetist 367500000X 155292 MA
Certified Registered Nurse Anesthetist 367500000X 050542 ME
Certified Registered Nurse Anesthetist 367500000X 053324-23-11 NH

Addresses

Primary practice location

995 Mar Walt Dr
Fort Walton Beach, FL 32547-6758

Mailing address

1405 Windward LN
Niceville, FL 32578-4343
Phone (850) 897-8978

Other identifiers 1

IdentifierTypeStateIssuer
000694196CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NH, ME3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040309000724 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547158735 Reassigns benefits to 4 organizations
I20100107000242 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547158735 Reassigns benefits to 2 organizations
I20181029001953 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547158735

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Care Group PC 35 clinicians
Anesthesia Dynamics LLC 883 clinicians

Practice addresses (Care Compare)

5 Alumni Dr
Exeter, NH 03833-2128
Phone (603) 778-7311

560 Jackson St N
Suite 200
St Petersburg, FL 33705-1449
Phone (727) 820-7500

Hospital & facility affiliations

  • Exeter Hospital Inc Hospital, Exeter, NH, CCN 300023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
155292MAMDCertified Registered Nurse Anesthetist
050542MEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jan 1, 2019 Accepting new patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 19, 2023 Accepting new patients
Mainehealth CurrentSince Jan 1, 2019 Accepting new patients
St Lucie Anesthesia Associates LLC CurrentSince Jul 1, 2015 Accepting new patients
Miami Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2022 Accepting new patients
St. Lucie Anesthesia Associates, LLC CurrentSince Jul 1, 2015 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2022 Accepting new patients
Anesthesia Care Group PC CurrentSince Feb 1, 2019 Accepting new patients
North American Partners in Anesthesia New Hampshire LLP CurrentSince Feb 1, 2019 Accepting new patients
Mainehealth Current Accepting new patients
Seacoast Anesthesia PA Past Accepting new patients
Broad Anesthesia Associates Past Accepting new patients

Locations

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

995 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 863-7887

306 E Hallandale Beach Blvd
Hallandale Beach, FL 33009
Phone (954) 458-1689

3995 NW Goldenrod Rd
Jensen Beach, FL 34957
Phone (772) 497-0020

201 W Guava St
Lady Lake, FL 32159
Phone (352) 391-5875

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

5959 NW 7th St
Miami, FL 33126
Phone (305) 264-1000

1670 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 541-3048

10521 SW Village Center Dr
Ste 104
Port St Lucie, FL 34987
Phone (772) 345-8600

560 Jackson St N
Ste 200
St Petersburg, FL 33705
Phone (727) 388-7326

2441 Oak Myrtle Ln
Wesley Chapel, FL 33544
Phone (813) 563-1144

35 Miles St
Damariscotta, ME 04543
Phone (207) 563-1234

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

5 Alumni Dr
Exeter, NH 03833
Phone (603) 580-6339

88 McGregor St
Ste 303
Manchester, NH 03102
Phone (603) 647-9325

8 Prospect St
Nashua, NH 03060
Phone (603) 281-9275

11 Whitehall Rd
Rochester, NH 03867
Phone (603) 330-7905

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306713600000",
    "number": "1053379917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 WINDWARD LN",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325784343",
            "telephone_number": "850-897-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476758",
            "telephone_number": "850-863-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELORO",
        "first_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2011-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP3065242",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "155292",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "050542",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "053324-23-11",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000694196C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.