Individual provider Active NPI

Michale L Kangelos, CSFA

  • Surgical Physician Assistant
  • Woodstock, GA
National Provider Identifier
1265772248
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
139732 Issued in GA
Practice address
313 Balaban Cir
Woodstock, GA 30188
Phone
(678) 848-4351
NPI assigned
Feb 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 139732 GA Primary

Addresses

Primary practice location

313 Balaban Cir
Woodstock, GA 30188

Mailing address

313 Balaban Cir
Woodstock, GA 30188-5189
Phone (678) 848-4351

Other practice location 1

305 Rose Pointe Ct
Bonaire, GA 31005-3648
Phone (678) 848-4351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
139732GAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Winkles Surgical Assisting Surgical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1265772248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 BALABAN CIR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301885189",
            "telephone_number": "678-848-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 BALABAN CIR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30188",
            "telephone_number": "678-848-4351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Rose Pointe Ct",
            "address_purpose": "LOCATION",
            "city": "Bonaire",
            "state": "GA",
            "postal_code": "310053648",
            "country_code": "US",
            "telephone_number": "678-848-4351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANGELOS",
        "first_name": "MICHALE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "CSFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-27",
        "last_updated": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "139732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.