Michael Deangelis DO PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

185967 Issued in NY

Legal business name

MICHAEL DEANGELIS DO PC

Practice address

70 Glen St Ste 380
Glen Cove, NY 11542-2858

Phone

(516) 674-7074

Fax

(516) 674-4768

NPI assigned

Aug 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Michael DeangelisNPI 1609962539

Title

DO PC

Phone

(516) 674-7074

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Richard Deangelis, D.O

  • Internal Medicine Physician
  • Glen Cove, NY
  • NPI 1609962539
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1346498714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 GLEN ST STE 380",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422858",
            "telephone_number": "516-674-7074",
            "fax_number": "516-674-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 GLEN ST STE 380",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422858",
            "telephone_number": "516-674-7074",
            "fax_number": "516-674-4768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL DEANGELIS DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-28",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "DEANGELIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DO PC",
        "authorized_official_telephone_number": "516-674-7074",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "185967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Glen Cove, NY
• Providers in Glen Cove, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.