Individual provider Active NPI

Cheryl Ann Angelo, O.D.

  • Optometrist
  • Mount Laurel, NJ
National Provider Identifier
1588734677
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4699 Issued in NJ
Practice address
813 E Gate Dr
Mount Laurel, NJ 08054-1238
Phone
(856) 642-7600
Fax
(856) 608-0501
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4699 NJ Primary

Addresses

Primary practice location

813 E Gate Dr
Mount Laurel, NJ 08054-1238

Mailing address

813 E Gate Dr
Mount Laurel, NJ 08054-1238
Phone (856) 642-7600

Other identifiers 1

IdentifierTypeStateIssuer
1350803MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20120220000613 NJ Practitioner - Optometry 5799943908 Reassigns benefits to 1 organization
Practice locations: Mt. Laurel, NJ

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3820 Church Rd
Mount Laurel, NJ 08054-1106
Phone (856) 642-7600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4699NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Angelo Eye Associates, Inc. Optometrist CurrentSince Nov 12, 2011 Accepting new patients

Locations

303 Lippincott Dr
Marlton, NJ 08053

3820 Church Rd
Mount Laurel, NJ 08054
Phone (856) 727-4774

813 E Gate Dr
Mount Laurel, NJ 08054
Phone (856) 273-8000

69 1st Ave
Raritan, NJ 08869
Phone (800) 631-5250

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588734677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 E GATE DR",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541238",
            "telephone_number": "856-642-7600",
            "fax_number": "856-608-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 E GATE DR",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541238",
            "telephone_number": "856-642-7600",
            "fax_number": "856-608-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELO",
        "first_name": "CHERYL",
        "middle_name": "ANN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "4699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1350803",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.