Individual provider Active NPI

Lisa Renee Angelesco, DNP, APRN, FNP-C

  • Adult Medicine Physician
  • Salem, OR
National Provider Identifier
1457118259
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
201708869RN Issued in OR
Practice address
374 Owens St SE
Salem, OR 97302-4183
Phone
(503) 972-0235
NPI assigned
Feb 28, 2024
Last updated
Oct 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 201708869RN OR Primary

Addresses

Primary practice location

374 Owens St SE
Salem, OR 97302-4183

Mailing address

374 Owens St SE
Salem, OR 97302-4183
Phone (503) 972-0235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20251114003321 OR Practitioner - Nurse Practitioner 6507357761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinicops LLCGroup PAC ID 9739343245, 25 clinicians

Practice addresses (Care Compare)

374 Owens St SE
Salem, OR 97302-4145
Phone (866) 972-0235

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201708869RNORMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicops LLC CurrentSince Oct 13, 2025 Accepting new patients
Clinicops, LLC CurrentSince Oct 13, 2025 Accepting new patients
Clinicops LLC PastSince May 25, 2025 Accepting new patients
Clinicops LLC PastSince May 25, 2025 Accepting new patients

Locations

3 River Ave
Eugene, OR 97404

2970 Highway 101
Florence, OR 97439
Phone (541) 902-0800

923 NW 14th Ave
Portland, OR 97209

374 Owens St SE
Salem, OR 97302
Phone (503) 399-1400

Interoperability endpoints

  • Direct secure messaging: lisa.angelesco.1@32746.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1457118259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 OWENS ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024183",
            "telephone_number": "503-972-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 OWENS ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024183",
            "telephone_number": "503-972-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELESCO",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-28",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OR",
            "license": "201708869RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.