Active NPI
Laura Deangelo
- Student in an Organized Health Care Education/Training Program
- Austin, TX
National Provider Identifier
1508107079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 5309 Beckett Cir
Austin, TX 78749-2114 - Phone
- (860) 966-6786
- NPI assigned
- Mar 8, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
5309 Beckett Cir
Austin, TX 78749-2114
Mailing address
5309 Beckett Cir
Austin, TX 78749-2114
Phone (860) 966-6786
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 25, 2022 through Feb 25, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9517 | CT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761868800000",
"number": "1508107079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5309 BECKETT CIR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787492114",
"telephone_number": "860-966-6786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5309 BECKETT CIR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787492114",
"telephone_number": "860-966-6786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEANGELO",
"first_name": "LAURA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-08",
"last_updated": "2025-10-31",
"certification_date": "2025-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.