Individual provider Active NPI

Michael Christopher Angelillo, DO

  • Internal Medicine Physician
  • Boca Raton, FL
National Provider Identifier
1386153807
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
UO4416 Issued in FL
Practice address
1601 Clint Moore Rd Ste 115
Boca Raton, FL 33487
Phone
(561) 997-8484
NPI assigned
Sep 27, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X UO4416 FL Primary

Addresses

Primary practice location

1601 Clint Moore Rd Ste 115
Boca Raton, FL 33487

Mailing address

1601 Clint Moore Rd Ste 115
Boca Raton, FL 33487-5712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190118000474 FL Practitioner - Internal Medicine 3779829320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ima of South Florida LLCGroup PAC ID 6406820414, 30 clinicians
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

1601 Clint Moore Rd
Suite 115
Boca Raton, FL 33487-5712
Phone (561) 997-8484

7015 Beracasa Way
Cora Physical Therapy W Boca Raton
Boca Raton, FL 33433-3453
Phone (561) 939-2033

800 Meadows Rd
Boca Raton, FL 33486-2304
Phone (561) 395-7100

Hospital & facility affiliations

  • Comfort Care Homecare Inc Home health agency, Boca Raton, FL, CCN 687128
  • Enhabit Home Health of Bethesda Home health agency, Boynton Beach, FL, CCN 107214
  • Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168
  • Delray Medical Center Hospital, Delray Beach, FL, CCN 100258

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
UO4416FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ima of South Florida LLC Internal Medicine CurrentSince Sep 3, 2018 Accepting new patients

Locations

1601 Clint Moore Rd
Ste 115
Boca Raton, FL 33487
Phone (561) 939-0760

Interoperability endpoints

  • Direct secure messaging: michael.angelillo.1@31574.direct.athenahealth.com

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.

Hospital & facility affiliations 4

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": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1386153807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CLINT MOORE RD STE 115",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334875712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CLINT MOORE RD STE 115",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33487",
            "telephone_number": "561-997-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELILLO",
        "first_name": "MICHAEL",
        "middle_name": "CHRISTOPHER",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-27",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "UO4416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.