NPIMap

Individual provider Active NPI

Katherine M Deangeli, MD

  • Surgery Physician
  • Appleton, WI
National Provider Identifier
1104211374
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
77316-20 Issued in WI
Practice address
2500 E Capitol Dr Ste 1700
Appleton, WI 54911-8735
Phone
(920) 731-8131
Fax
(920) 832-0444
NPI assigned
Apr 3, 2015
Last updated
Jul 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Surgery Physician 208600000X 77316-20 WI Primary

Addresses

Primary practice location

2500 E Capitol Dr Ste 1700
Appleton, WI 54911-8735

Mailing address

2000 E Milestone Dr
Appleton, WI 54913-6701
Phone (920) 731-8131

Other practice location 1

2000 E Milestone Dr
Appleton, WI 54913-6701
Phone (920) 731-8131

Other identifiers 2

IdentifierTypeStateIssuer
77316-20OtherWILICENSE
100211567MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221017002775 WI Practitioner - General Surgery 8921344169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Wisconsin, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Valley Surgical Associates LTDGroup PAC ID 7911971296, 35 clinicians

Practice addresses (Care Compare)

2000 E Milestone Dr
Appleton, WI 54913-6701
Phone (920) 731-8131

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy13
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77316-20WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Valley Surgical Associates LTD Surgery CurrentSince Nov 1, 2022 Accepting new patients
Fox Valley Pulmonary Medicine, S.C. PastSince Nov 1, 2022 Accepting new patients
Fox Valley Surgical Associates PastSince Sep 1, 2022 Accepting new patients

Locations

1818 N Meade St
Ste 240W
Appleton, WI 54911

2000 E Milestone Dr
Appleton, WI 54913
Phone (920) 358-1729

2500 E Capitol Dr
Ste 1700
Appleton, WI 54911
Phone (920) 734-9600

Organizations & group practices 3

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 12

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": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1104211374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 E MILESTONE DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549136701",
            "telephone_number": "920-731-8131",
            "fax_number": "920-832-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E CAPITOL DR STE 1700",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118735",
            "telephone_number": "920-731-8131",
            "fax_number": "920-832-0444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 E Milestone Dr",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549136701",
            "country_code": "US",
            "telephone_number": "920-731-8131",
            "fax_number": "920-832-0444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEANGELI",
        "first_name": "KATHERINE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "77316-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "77316-20",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100211567",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.