Patricia Ann Angelucci, NP
Individual provider Active NPI Gerontology Nurse Practitioner · Appleton, WI
NPI 1134465636 · NPPES record last updated Dec 19, 2016
Key facts
- NPI
- 1134465636
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- APNP #5127-33 (WI)
- Practice address
- 2600 S Heritage Woods Dr
Appleton, WI 54915-1408 - Phone
- (920) 225-7875
- Fax
- (920) 993-5003
- NPI assigned
- Jan 2, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (7 enrollments) in WI, FL, PA, MA, NY, MN, MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141224000889 | WI | Practitioner - Nurse Practitioner | 8729184650 | |
| I20200512003183 | FL | Practitioner - Nurse Practitioner | 8729184650 | Reassigns benefits to 2 organizations |
| I20220223000038 | PA | Practitioner - Nurse Practitioner | 8729184650 | Reassigns benefits to 1 organization |
| I20220302002784 | MA | Practitioner - Nurse Practitioner | 8729184650 | Reassigns benefits to 1 organization |
| I20220307000889 | NY | Practitioner - Nurse Practitioner | 8729184650 | |
| I20230511003177 | MN | Practitioner - Nurse Practitioner | 8729184650 | |
| I20230711000977 | MD | Practitioner - Nurse Practitioner | 8729184650 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7322 | MN | MD | Chiropractor |
| 340991 | NY | MD | Family Nurse Practitioner |
| APNP #5127-33 | WI | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mana Health Partners PA | Current |
Accepting new patients | |
| Adam C Perry MD PA | Current |
Accepting new patients |
Locations
991 Pondella Rd
North Ft Myers, FL 33903
Phone (239) 994-8809
1501 SE 24th Rd
Ocala, FL 34471
Phone (352) 257-7777
1507 S Tuttle Ave
Sarasota, FL 34239
Phone (941) 366-0336
84 State St
Boston, MA 02109
Phone (855) 777-2244
338 Whitesville Rd
Ste 103
Jackson, NJ 08527
5235 N Front St
Harrisburg, PA 17110
Phone (973) 566-1826
211 E 7th St
Ste 620
Austin, TX 78701
Phone (415) 742-8411
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | APNP #5127-33 | WI | Yes |
Addresses
Primary practice location
2600 S Heritage Woods Dr
Appleton, WI 54915-1408
Mailing address
PO Box 8003
Appleton, WI 54912-8003
Phone (920) 996-3200
Other providers in Appleton, WI
- Michael Floyd Anderson
- William A Anderson
- Joshua Paul Andreini
- Brandi Andrews
- Shannon Andrews
- Rhonda Joy Anglea
- Wendy Antoine
- Anthony Michael Appl
- Apple Creek LTD
- Apple Creek Oral Surgery, SC
All providers in Appleton, WI · Gerontology Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.