Active NPI
David Angelillo
- Orthopaedic Surgery Physician
- New York, NY
National Provider Identifier
1497959464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 253396
- Practice address
- 301 E 17TH St
Room 1402
New York, NY 10003-3804 - Phone
- (212) 598-6509
- NPI assigned
- Jun 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 253396 | NY | Primary |
Addresses
Primary practice location
301 E 17TH St
Room 1402
New York, NY 10003-3804
Mailing address
148 Earl St
Westbury, NY 11590-2945
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110329000646 | NY | Practitioner - Orthopedic Surgery | 7618150699 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Peconic Bay Primary Medical Care
Practice addresses (Care Compare)
64 Commerce Ave
Riverhead, NY 11901-4455
Phone (631) 369-5000
Hospital & facility affiliations
- Peconic Bay Medical Center
- Suny/Stony Brook University Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 1-10 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 12 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 18 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 253396 | NY | MD | Orthopaedic Surgery Physician |
Practice roles (1 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peconic Bay Primary Medical Care | Current | Accepting new patients |
Locations
496 County Road 111
Bldg D1
Manorville, NY 11949
Phone (631) 909-8712
496 County Road 111
Bldg B
Manorville, NY 11949
Phone (631) 405-3200
34 Commerce Ave
Riverhead, NY 11901
Phone (631) 591-3000
31 Main Rd
Ste 3
Riverhead, NY 11901
Phone (631) 405-3238
64 Commerce Ave
Riverhead, NY 11901
Phone (631) 369-5000
855 Montauk Hwy
Shirley, NY 11967
Phone (631) 651-4900
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
Interoperability endpoints
- dangelillo70396@northwell.direct-ci.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
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 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1033224704
Hospital
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1225507114
Hospital
-
- General Acute Care Hospital
- Greenport, NY
- NPI 1881690691
Hospital
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247702400000",
"number": "1497959464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 EARL ST",
"city": "WESTBURY",
"state": "NY",
"postal_code": "115902945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E 17TH ST",
"address_2": "ROOM 1402",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100033804",
"telephone_number": "212-598-6509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANGELILLO",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-13",
"last_updated": "2009-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "NY",
"license": "253396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; 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.