Individual provider Active NPI

John James D'Angelo Jr., M.D.

  • Emergency Medicine Physician
  • Grantsville, WV
National Provider Identifier
1124221023
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
23571 Issued in WV
Practice address
186 Hospital Dr
Grantsville, WV 26147-7100
Phone
(304) 354-9244
Fax
(304) 354-9323
NPI assigned
Jun 7, 2007
Last updated
Dec 3, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 23571 WV Primary

Addresses

Primary practice location

186 Hospital Dr
Grantsville, WV 26147-7100

Mailing address

186 Hospital Dr
Grantsville, WV 26147-7100
Phone (304) 354-6244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20160401001429 ID Practitioner - Emergency Medicine 1052443215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.09 of 100Reported as group
Quality
77.1
Promoting interoperability
100
Improvement activities
40
Cost
73.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23571WVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Clinic LLC CurrentSince Oct 1, 2016 Accepting new patients
Minnie Hamilton Health Care Center, Inc. Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230

801 Pole Line Rd W
Twin Falls, ID 83301
Phone (208) 814-1000

Interoperability endpoints

  • Direct secure messaging: jdangelo37783@direct.slhs.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291334400000",
    "number": "1124221023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 HOSPITAL DR",
            "city": "GRANTSVILLE",
            "state": "WV",
            "postal_code": "261477100",
            "telephone_number": "304-354-6244",
            "fax_number": "304-354-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 HOSPITAL DR",
            "city": "GRANTSVILLE",
            "state": "WV",
            "postal_code": "261477100",
            "telephone_number": "304-354-9244",
            "fax_number": "304-354-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ANGELO",
        "first_name": "JOHN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2010-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "23571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grantsville, WV

Sources for this page

Verify at the official NPI Registry.