Individual provider Active NPI

Erin Angelo, CNP

  • Family Nurse Practitioner
  • Beachwood, OH
National Provider Identifier
1558112862
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0035623 Issued in OH
Practice address
3737 Park East Dr Ste 109
Beachwood, OH 44122-4329
Phone
(216) 464-7333
NPI assigned
Mar 27, 2024
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0035623 OH Primary

Addresses

Primary practice location

3737 Park East Dr Ste 109
Beachwood, OH 44122-4329

Mailing address

36000 Euclid Avenue
Willoughby, OH 44094-4625
Phone (440) 918-6341

Other identifiers 1

IdentifierTypeStateIssuer
APRN.CNP.0035623OtherOHMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240504000168 OH Practitioner - Nurse Practitioner 3678913837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gregory P Kezele MD LLCGroup PAC ID 3072992130, 2 clinicians
Parker Skin and Aesthetic Clinic IncGroup PAC ID 4587614813, 10 clinicians

Practice addresses (Care Compare)

3600 Euclid Ave
Willoughby, OH 44094-4625
Phone (440) 413-0499

3737 Park E Dr
Suite 109
Beachwood, OH 44122-4329
Phone (216) 464-7333

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0035623OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Parker Skin & Aesthetic Clinic Inc. CurrentSince Apr 15, 2024 Accepting new patients
Gregory P Kezele MD LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

3737 Park East Dr
Ste 109
Beachwood, OH 44122
Phone (216) 464-7333

2001 Crocker Rd
Ste 150
Westlake, OH 44145
Phone (440) 235-8484

36000 Euclid Ave
Willoughby Hills, OH 44094
Phone (440) 375-8166

Interoperability endpoints

  • Direct secure messaging: eangelo627961@ehrdirect.uhhospitals.org

Organizations & group practices 2

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": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1558112862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36000 EUCLID AVENUE",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944625",
            "telephone_number": "440-918-6341",
            "fax_number": "440-918-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 PARK EAST DR STE 109",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224329",
            "telephone_number": "216-464-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELO",
        "first_name": "ERIN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0035623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "APRN.CNP.0035623",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.