Angelina Kelly Viscardi Waller, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2178 Issued in CO

Practice address

11960 Lioness Way Ste 260
Parker, CO 80134

Phone

(303) 344-9090

Fax

(720) 895-1121

NPI assigned

Aug 19, 2006

Last updated

Jun 6, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic Centers of Colorado LLCGroup PAC ID 2365714540, 327 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

43.24 of 100Reported as group

Quality

73.53

Promoting interoperability

0

Improvement activities

0

Cost

70.6

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Orthopedic Centers of Colorado, LLC

  dba Perioperative Medicine Care Center

  • Orthopaedic Surgery Physician
  • Denver, CO
  • NPI 1801339502
  Medicare reassignment Care Compare group NPD
• Orthopedic Centers of Colorado, LLC

  • Orthopaedic Surgery Physician
  • Superior, CO
  • NPI 1336870856
  NPD

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1417061821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 E LOWRY BLVD STE 230",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307195",
            "telephone_number": "303-344-9090",
            "fax_number": "303-344-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11960 LIONESS WAY STE 260",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "80134",
            "telephone_number": "303-344-9090",
            "fax_number": "720-895-1121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8101 E Lowry Blvd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802307195",
            "country_code": "US",
            "telephone_number": "303-344-9090",
            "fax_number": "303-344-1922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLER",
        "first_name": "ANGELINA",
        "middle_name": "KELLY VISCARDI",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2178",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "2178",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Walker
• Leah Walker, PT
• Alison Wall, MS CCC-SLP
• Brenda Lanette Wallace
• Moriah Jasmine Wallace
• Walmart Inc. (Walmart Pharmacy 10-2892)
• Walmart Pharmacy
• Amanda Rachel Waltemeyer, RDH
• Wanda Good DO, LLC
• Melissa Beth Wang, RN

• Medical Physician Assistant in Parker, CO
• Providers in Parker, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.
• 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.