Individual provider Active NPI

Angela Christine Edgell, PAC

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1104549476
Registry record updated May 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0008247 Issued in CO
Practice address
777 Bannock St
Denver, CO 80204-4507
Phone
(303) 436-4949
NPI assigned
Sep 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA064008 PA
Physician Assistant 363A00000X PA.0008247 CO Primary

Addresses

Primary practice location

777 Bannock St
Denver, CO 80204-4507

Mailing address

200 Pond Vista LN Apt K
Manheim, PA 17545-9816
Phone (717) 333-9387

Other practice location 1

170 N Pointe Blvd
Lancaster, PA 17601-4132
Phone (717) 299-4871

Other practice location 2

212 Willow Valley Lakes Dr Ste 109
Willow Street, PA 17584-9668
Phone (717) 299-4871

Other practice location 3

2913 Spooky Nook Rd Ste 100
Manheim, PA 17545-9149
Phone (717) 299-4871

Other practice location 4

1701 Cornwall Rd Ste 200
Lebanon, PA 17042-7480
Phone (717) 299-4871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221101001964 PA Practitioner - Physician Assistant 6800263039
I20240724003452 CO Practitioner - Physician Assistant 6800263039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Denver Health and Hospital AuthorityGroup PAC ID 4688583578, 830 clinicians

Practice addresses (Care Compare)

777 Bannock St
Denver, CO 80204-4507
Phone (303) 436-6000

Hospital & facility affiliations

  • Denver Health & Hospital Authority Hospital, Denver, CO, CCN 060011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0008247COMDPhysician Assistant
MA064008PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Jun 30, 2024 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jun 30, 2024 Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

777 Bannock St
#1923
Denver, CO 80204
Phone (303) 602-2720

777 Bannock St
Ste MC3450
Denver, CO 80204

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: aedgell298487@direct.dhha.org

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 and National Provider Directory roles.

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": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714867200000",
    "number": "1104549476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 POND VISTA LN APT K",
            "city": "MANHEIM",
            "state": "PA",
            "postal_code": "175459816",
            "telephone_number": "717-333-9387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507",
            "telephone_number": "303-436-4949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 N Pointe Blvd",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176014132",
            "country_code": "US",
            "telephone_number": "717-299-4871",
            "fax_number": "717-391-2494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "212 Willow Valley Lakes Dr Ste 109",
            "address_purpose": "LOCATION",
            "city": "Willow Street",
            "state": "PA",
            "postal_code": "175849668",
            "country_code": "US",
            "telephone_number": "717-299-4871",
            "fax_number": "717-391-2494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2913 Spooky Nook Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Manheim",
            "state": "PA",
            "postal_code": "175459149",
            "country_code": "US",
            "telephone_number": "717-299-4871",
            "fax_number": "717-391-2494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 Cornwall Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170427480",
            "country_code": "US",
            "telephone_number": "717-299-4871",
            "fax_number": "717-391-2494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDGELL",
        "first_name": "ANGELA",
        "middle_name": "CHRISTINE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2024-05-05",
        "certification_date": "2024-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA064008",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0008247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.