Individual provider Active NPI

M Shane Angleton, P.A.

  • Medical Physician Assistant
  • Camden, NY
National Provider Identifier
1447280508
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
003097-1 Issued in NY
Practice address
9562 State Route #13
Camden, NY 13316-4940
Phone
(315) 245-5029
Fax
(315) 245-5056
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 003097-1 NY Primary

Addresses

Primary practice location

9562 State Route #13
Camden, NY 13316-4940

Mailing address

9562 State Route #13
Camden, NY 13316-4940
Phone (315) 245-5029

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090402000644 NY Practitioner - Physician Assistant 9739236092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oneida Medical Practice PC 51 clinicians

Practice addresses (Care Compare)

301 Genesee St
Oneida, NY 13421-2644

301 Genesee St-Attn Neurology
Suite C
Oneida, NY 13421-2644
Phone (315) 361-2377

357 Genesee St
Suite 2
Oneida, NY 13421-2658
Phone (315) 363-4651

9562 State Route 13
Camden, NY 13316-4940
Phone (315) 245-5029

Hospital & facility affiliations

  • Oneida Health Hospital Hospital, Oneida, NY, CCN 330115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3097NYMDSpeech-Language Pathologist
003097-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oneida Medical Practice, PC CurrentSince Jan 1, 2024 Accepting new patients
Primary Care Metabolic Disorders Medical Practice, PLLC PastSince Feb 23, 2020 Accepting new patients
Sleep Disorders Lab of Central New York, LLC Past Accepting new patients

Locations

9562 State Route 13
Camden, NY 13316
Phone (315) 245-1388

301 Genesee St
Ste C
Oneida, NY 13421
Phone (315) 361-2377

321 Genesee St
Oneida, NY 13421
Phone (315) 361-2020

Interoperability endpoints

  • Direct secure messaging: sangleton@ompohc.medentdirect.com
  • Direct secure messaging: mangleton@rmh.medalliesdirect.net

Organizations & group practices 4

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1447280508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9562 STATE ROUTE #13",
            "city": "CAMDEN",
            "state": "NY",
            "postal_code": "133164940",
            "telephone_number": "315-245-5029",
            "fax_number": "315-245-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9562 STATE ROUTE #13",
            "city": "CAMDEN",
            "state": "NY",
            "postal_code": "133164940",
            "telephone_number": "315-245-5029",
            "fax_number": "315-245-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGLETON",
        "first_name": "M",
        "middle_name": "SHANE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "003097-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NY

Sources for this page

Verify at the official NPI Registry.