Individual provider Active NPI

Nathan Christopher Deangelis, D.O.

  • Surgery Physician
  • Lake Mary, FL
National Provider Identifier
1063651131
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OS11555 Issued in FL
Practice address
4106 W Lake Mary Blvd Ste 100
Lake Mary, FL 32746-3344
Phone
(407) 562-5930
Fax
(407) 562-5931
NPI assigned
Feb 13, 2009
Last updated
Jan 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OS11555 FL Primary
Surgery Physician 208600000X 125-051776 IL

Addresses

Primary practice location

4106 W Lake Mary Blvd Ste 100
Lake Mary, FL 32746-3344

Mailing address

4106 W Lake Mary Blvd Ste 100
Lake Mary, FL 32746-3344
Phone (407) 562-5930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120802000450 FL Practitioner - General Surgery 8820266901 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Philadelphia College of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians
Osceola Surgical Associates LLCGroup PAC ID 0840366126, 36 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

631 E Altamonte Dr
Suite 231
Altamonte Springs, FL 32701-4802
Phone (407) 303-5214

8400 Red Bug Lake Rd
Suite 1010
Oviedo, FL 32765-6835
Phone (407) 890-4990

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS11555FLMDSurgery Physician
125-051776ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osceola Surgical Associates LLC Surgery CurrentSince Dec 15, 2025 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Oct 8, 2015 Accepting new patients
Florida Hospital Medical Group Inc Surgery CurrentSince Oct 8, 2015 Accepting new patients
Osceola Surgical Associates LLC Surgery Past Accepting new patients

Locations

2450 N Orange Blossom Trl
Kissimmee, FL 34744
Phone (407) 846-4343

4106 W Lake Mary Blvd
Ste 225
Lake Mary, FL 32746
Phone (407) 548-6530

4106 W Lake Mary Blvd
Ste 330
Lake Mary, FL 32746
Phone (386) 775-2012

4106 W Lake Mary Blvd
Ste 100
Lake Mary, FL 32746
Phone (407) 333-2273

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

8400 Red Bug Lake Rd
Ste 1010
Oviedo, FL 32765
Phone (407) 833-7505

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 4

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

Hospital & facility affiliations 3

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": "1234483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1063651131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4106 W LAKE MARY BLVD STE 100",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463344",
            "telephone_number": "407-562-5930",
            "fax_number": "407-562-5931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4106 W LAKE MARY BLVD STE 100",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463344",
            "telephone_number": "407-562-5930",
            "fax_number": "407-562-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELIS",
        "first_name": "NATHAN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-13",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS11555",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125-051776",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.