Individual provider Active NPI

Debra Gail Angelo, M.D.

  • Internal Medicine Physician
  • Trinity, FL
National Provider Identifier
1174852362
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME108038 Issued in FL
Practice address
9332 State Road 54 Ste 302
Trinity, FL 34655-1810
Phone
(727) 834-4450
Fax
(727) 816-2151
NPI assigned
Dec 17, 2009
Last updated
May 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-094510 OH
Internal Medicine Physician 207R00000X ME108038 FL Primary
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X ME108038 FL

Addresses

Primary practice location

9332 State Road 54 Ste 302
Trinity, FL 34655-1810

Mailing address

PO Box 645743
Cincinnati, OH 45264-5743
Phone (855) 689-5105

Other identifiers 1

IdentifierTypeStateIssuer
110400300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, WY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101109001425 FL Practitioner - Internal Medicine 6204971393 Reassigns benefits to 3 organizations
I20240318001504 WY Practitioner - Internal Medicine 6204971393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nautilus Health Care Group LLCGroup PAC ID 5991604852, 51 clinicians
Hospital Medicine Services of FL, LLCGroup PAC ID 9234596743, 513 clinicians
Teton County Hospital DistrictGroup PAC ID 4880582295, 107 clinicians

Practice addresses (Care Compare)

11371 Cortez Blvd
Suite 134
Brooksville, FL 34613-5408
Phone (352) 606-7182

340 NW Commerce Dr
Lake City Medical Center
Lake City, FL 32055-4709
Phone (850) 719-9000

625 E Broadway Ave
Jackson, WY 83001-8642
Phone (307) 733-3636

9330
54 Medical Center of Trinity
Trinity, FL 34655-1808
Phone (727) 845-9115

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.82 of 100Reported as group
Quality
67.1
Promoting interoperability
98
Improvement activities
40
Cost
73.98

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-094510OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nautilus Health Care Group, LLC Undersea and Hyperbaric Medicine CurrentSince Apr 1, 2022 Accepting new patients
Teton County Hospital District CurrentSince Mar 5, 2024 Accepting new patients
Hospital Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
Nautilus Health Care Group LLC Internal Medicine CurrentSince Apr 1, 2022 Accepting new patients
Advanced Wound Systems LLC Past Accepting new patients
Oak Hill Hospitalist, LLC Internal Medicine Past Accepting new patients

Locations

11371 Cortez Blvd
Ste 134
Brooksville, FL 34613
Phone (352) 606-7182

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

7525 Medical Dr
Hudson, FL 34667
Phone (727) 869-5551

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

1500 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 368-4410

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

1609 Pasadena Ave S
Ste 2N
South Pasadena, FL 33707
Phone (727) 398-6650

6500 38th Ave N
St Petersburg, FL 33710
Phone (727) 341-4870

1120 Pinellas Bayway S
Ste 200
Tierra Verde, FL 33715
Phone (727) 867-5480

9330 State Road 54
Trinity, FL 34655
Phone (727) 834-4000

9332 State Road 54
Ste 302
Trinity, FL 34655
Phone (727) 834-4442

11375 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 596-4209

Interoperability endpoints

  • Direct secure messaging: debra.angelo@hca4.eclinicaldirectplus.com

Organizations & group practices 7

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 4

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": "1261008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1174852362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645743",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452645743",
            "telephone_number": "855-689-5105",
            "fax_number": "888-507-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9332 STATE ROAD 54 STE 302",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551810",
            "telephone_number": "727-834-4450",
            "fax_number": "727-816-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELO",
        "first_name": "DEBRA",
        "middle_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-17",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-094510",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME108038",
            "primary": true
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "FL",
            "license": "ME108038",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110400300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

Verify at the official NPI Registry.