Active NPI
Nicolas Joseph Pietrangelo, D.O.
- General Practice Physician
- Spring Lake, MI
National Provider Identifier
1528293925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 5101006774
- Practice address
- 19212 N Shore Dr
Spring Lake, MI 49456-9109 - Phone
- (616) 842-6813
- NPI assigned
- May 28, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 5101006774 | MI | |
| General Practice Physician | 208D00000X | 5101006774 | MI | Primary |
Addresses
Primary practice location
19212 N Shore Dr
Spring Lake, MI 49456-9109
Mailing address
19212 N Shore Dr
Spring Lake, MI 49456-9109
Phone (616) 842-6813
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101006774 | MI | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243468800000",
"number": "1528293925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19212 N SHORE DR",
"city": "SPRING LAKE",
"state": "MI",
"postal_code": "494569109",
"telephone_number": "616-842-6813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19212 N SHORE DR",
"city": "SPRING LAKE",
"state": "MI",
"postal_code": "494569109",
"telephone_number": "616-842-6813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIETRANGELO",
"first_name": "NICOLAS",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-28",
"last_updated": "2009-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "5101006774",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MI",
"license": "5101006774",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Lake, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.