Brock Randall Angelos, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

194 Issued in NE

Practice address

4213 O St
Lincoln, NE 68510-1751

Phone

(402) 488-8114

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ashland Assisted Living

  • Assisted Living Facility
  • Ashland, NE
  • NPI 1114210044
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508978693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 O ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685101751",
            "telephone_number": "402-488-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 O ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685101751",
            "telephone_number": "402-488-8114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELOS",
        "first_name": "BROCK",
        "middle_name": "RANDALL",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NE",
            "license": "194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02593",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47070731200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anew Shared Living Provders, LLC
• Ilham I Angalo
• Jolene Angel
• Kristiana Joy Angelbeck, CNA
• Erin Angeli
• Linda Ankomah
• Jason Ankrah
• Anne Elizabeth Tapley PHD
• Anne Gilligan Psychotherapy, P.C.
• Anne Tapley PH.D., LLC

• Podiatrist in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Podiatrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.