Angela Dawn Earhart, M.D.

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

M4767 Issued in TX

Practice address

350 Kingwood Medical Drive
Suite 215
Kingwood, TX 77339-4412

Phone

(832) 978-5611

Fax

(281) 205-0204

NPI assigned

Oct 19, 2006

Last updated

Feb 14, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Angela Dawn Ianculovili Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Obstetrics/Gynecology

Education

University of Texas Medical School at Houston, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Angela Earhart P.a.

  • Specialist
  • Kingwood, TX
  • NPI 1588942395
  Medicare reassignment NPD
• South Texas Ultrasound LLC

  • Specialist
  • Houston, TX
  • NPI 1689053977
  Authorized official Same address or phone
• PMG Ultrasound

  • Mobile Radiology Clinic/Center
  • Houston, TX
  • NPI 1356154199

  Maternal & Fetal Medicine

  NPD

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1326120734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 KINGWOOD MEDICAL DRIVE",
            "address_2": "SUITE 215",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773394412",
            "telephone_number": "832-978-5611",
            "fax_number": "281-205-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 KINGWOOD MEDICAL DRIVE",
            "address_2": "SUITE 215",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773394412",
            "telephone_number": "832-978-5611",
            "fax_number": "281-205-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARHART",
        "first_name": "ANGELA",
        "middle_name": "DAWN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "TX",
            "license": "M4767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185571006",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8BZ693",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "IANCULOVILI",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Maternal & Fetal Medicine Physician in Kingwood, TX
• Providers in Kingwood, TX by specialty
• Maternal & Fetal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.