Individual provider Active NPI

Augusto P. Angulo, MD

  • Psychiatry Physician
  • Glen Head, NY
National Provider Identifier
1376637694
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
198958 Issued in NY
Practice address
27 Dolly Cam LN
Glen Head, NY 11545-2023
Phone
(718) 240-8000
NPI assigned
Oct 3, 2006
Last updated
Jun 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 198958 NY Primary

Addresses

Primary practice location

27 Dolly Cam LN
Glen Head, NY 11545-2023

Mailing address

27 Dolly Cam LN
Glen Head, NY 11545-2023
Phone (718) 240-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20041118000897 NY Practitioner - PsychiatryPractitioner - Internal Medicine 0941264931 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Internal Medicine
Education
Other, 1989
Medicare assignment
May accept Medicare assignment
Group practices
The Long Island HomeGroup PAC ID 8224055108, 22 clinicians

Practice addresses (Care Compare)

400 Sunrise Hwy
Amityville, NY 11701-2508
Phone (631) 608-5149

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
198958NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Sep 11, 2015 Accepting new patients
The Long Island Home CurrentSince Aug 5, 2024 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Mar 1, 2012 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Mar 1, 2012 Accepting new patients
The Long Island Home CurrentSince Aug 5, 2024 Accepting new patients

Locations

400 Sunrise Hwy
Amityville, NY 11701
Phone (631) 264-4000

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1335 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7507

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

7559 263rd St
Glen Oaks, NY 11004
Phone (718) 470-8005

300 Community Dr
Manhasset, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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 3

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1376637694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 DOLLY CAM LN",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115452023",
            "telephone_number": "718-240-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 DOLLY CAM LN",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115452023",
            "telephone_number": "718-240-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGULO",
        "first_name": "AUGUSTO",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "198958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Head, NY

Sources for this page

Verify at the official NPI Registry.