Individual provider Active NPI

Angelo Robert Consiglio, MD

  • Otolaryngology Physician
  • Marianna, FL
National Provider Identifier
1396791638
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME101216 Issued in FL
Practice address
4306 3Rd Avenue,
Suite a
Marianna, FL 32446
Phone
(850) 718-2886
Fax
(850) 633-5909
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngic Allergy Physician 207YX0602X ME101216 FL
Otolaryngology Physician 207Y00000X ME101216 FL Primary

Addresses

Primary practice location

4306 3Rd Avenue,
Suite a
Marianna, FL 32446

Mailing address

4250 Hospital Dr
Marianna, FL 32446-1917
Phone (850) 526-2200

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
I20100604000639 FL Practitioner - OtolaryngologyPractitioner - Allergy/Immunology 6305807090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Allergy/Immunology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ER Physician Group at Jackson HospitalGroup PAC ID 8729059472, 153 clinicians

Practice addresses (Care Compare)

4250 Hospital Dr
Marianna, FL 32446-1917
Phone (850) 526-2200

4306 3Rd Ave
Marianna, FL 32446-2121

Hospital & facility affiliations

  • Jackson Hospital Hospital, Marianna, FL, CCN 100142

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME101216FLMDOtolaryngic Allergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ER Physician Group at Jackson Hospital CurrentSince Jun 1, 2015 Accepting new patients
Midwest Ear, Nose & Throat Consultants, LTD. Otolaryngology Past Accepting new patients
Allergy Ear Nose Throat,LTD Otolaryngology PastSince Jun 1, 2006 Accepting new patients

Locations

4306 3rd Ave
Ste B
Marianna, FL 32446
Phone (850) 372-4070

4306 3rd Ave
Ste A
Marianna, FL 32446
Phone (850) 482-4820

4250 Hospital Dr
Marianna, FL 32446
Phone (850) 526-2200

Interoperability endpoints

  • Direct secure messaging: angeloconsiglio@jh.allscriptsdirect.net

Organizations & group practices 3

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 1

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396791638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 HOSPITAL DR",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324461917",
            "telephone_number": "850-526-2200",
            "fax_number": "850-718-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4306 3RD AVENUE,",
            "address_2": "SUITE A",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "32446",
            "telephone_number": "850-718-2886",
            "fax_number": "850-633-5909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSIGLIO",
        "first_name": "ANGELO",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "FL",
            "license": "ME101216",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME101216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marianna, FL

Sources for this page

Verify at the official NPI Registry.