Individual provider Active NPI

Michael Richard Deangelis, D.O

  • Internal Medicine Physician
  • Glen Cove, NY
National Provider Identifier
1609962539
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
185967 Issued in NY
Practice address
70 Glen St Ste 380
Glen Cove, NY 11542-2858
Phone
(516) 674-7074
Fax
(516) 674-4768
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 185967 NY Primary

Addresses

Primary practice location

70 Glen St Ste 380
Glen Cove, NY 11542-2858

Mailing address

70 Glen St Ste 380
Glen Cove, NY 11542-2858
Phone (516) 674-7074

Other identifiers 15

IdentifierTypeStateIssuer
542716OtherNYAETNA
P746167OtherOXFORD
01836722MedicaidNY
185967OtherHIP
44543OtherVYTRA
113517950OtherMAGNACARE
6368053004OtherCIGNA
24044OtherNYANTHEM
113517950-001OtherPRUDENTIAL
477230OtherPHCS
00000080229OtherBETTER HEALTH
113517950OtherMULTIPLAN
1297667OtherUNITED HEALTHCARE
2599070OtherGHI
2C4152OtherHEALTHNET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040120000803 NY Practitioner - Internal MedicinePractitioner - General Practice 4688575723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

117 Post Ave
Westbury, NY 11590-3178
Phone (516) 333-9828

2 Medical PLZ
Glen Cove, NY 11542-2108
Phone (516) 671-0858

6 Medical PLZ
Glen Cove, NY 11542-2108
Phone (516) 671-9010

70 Glen St
Suite 380
Glen Cove, NY 11542-2858
Phone (516) 674-7074

Hospital & facility affiliations

  • Tender Loving Care, an Amedisys Company Home health agency, Carle Place, NY, CCN 337143
  • North Shore Home Care Chha Home health agency, Westbury, NY, CCN 337148
  • Emerest Home Health Care of Long Island Home health agency, Flushing, NY, CCN 337189
  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • Northwell Hospital Glen Cove Hospital, Glen Cove, NY, CCN 330181
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182

Merit-based Incentive Payment System (MIPS)

Final score
21.53 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
71.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Deangelis DO PC Internal Medicine CurrentSince Jul 28, 2008 Accepting new patients
United Cerebral Palsy Association of Nassau County, Inc. CurrentSince May 26, 2015 Accepting new patients
Glen Cove Hospital Past Accepting new patients
United Cerebral Palsy Associations of New York State Inc Past Accepting new patients

Locations

8 Medical Plz
Ste 202
Glen Cove, NY 11542
Phone (516) 674-7074

70 Glen St
Ste 380
Glen Cove, NY 11542
Phone (516) 277-1153

380 Washington Ave
Roosevelt, NY 11575
Phone (516) 375-2000

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1609962539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 GLEN ST STE 380",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422858",
            "telephone_number": "516-674-7074",
            "fax_number": "516-674-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 GLEN ST STE 380",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422858",
            "telephone_number": "516-674-7074",
            "fax_number": "516-674-4768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELIS",
        "first_name": "MICHAEL",
        "middle_name": "RICHARD",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "185967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "542716",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P746167",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01836722",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "185967",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "44543",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGNACARE",
            "identifier": "113517950",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6368053004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "24044",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRUDENTIAL",
            "identifier": "113517950-001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "477230",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BETTER HEALTH",
            "identifier": "00000080229",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "113517950",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1297667",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2599070",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2C4152",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.