Angela Porcelli, APNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

6434-33 Issued in WI

Practice address

1611 S Madison St
Appleton, WI 54915-1844

Phone

(920) 730-5380

NPI assigned

Jul 2, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Angela Menos Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angela.porcelli.1@10114.direct.athenahealth.com

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.

• Fox Valley Pulmonary Medicine, S.C.

  • Pulmonary Disease Physician
  • Appleton, WI
  • NPI 1366506016
  Medicare reassignment NPD

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1366825820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E CAPITOL DR STE 1700",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118735",
            "telephone_number": "920-734-9600",
            "fax_number": "920-734-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 S MADISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151844",
            "telephone_number": "920-730-5380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "WI",
            "postal_code": "549231243",
            "country_code": "US",
            "telephone_number": "920-361-5975",
            "fax_number": "920-361-6339",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Theda Clark Medical Plz Ste 480",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549562790",
            "country_code": "US",
            "telephone_number": "920-729-0608",
            "fax_number": "920-729-2902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 E Capitol Dr Ste 1700",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "54911",
            "country_code": "US",
            "telephone_number": "920-734-9600",
            "fax_number": "920-734-4773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORCELLI",
        "first_name": "ANGELA",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2021-07-08",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6434-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6434-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366825820",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "angela.porcelli.1@10114.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1611 S Madison St",
            "city": "Appleton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549151844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "MENOS",
            "credential": "APNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eve Lyn Pomrening, APNP
• Rachel Pontius, OTR
• Mark Garold Pontow
• Paul Francis Popelka, DDS
• Amy Poppy, PHARMD
• Ann K Porretto-Loehrke, PT, DPT, CHT, COMT
• Lisa Marie Portmann, LCSW SAC
• Lori Poss, NP
• Michael Edward Possin, M.D.
• Kayla Powers Carr

• Nurse Practitioner in Appleton, WI
• Providers in Appleton, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.