Individual provider Active NPI

Angela Fanella Ebert, PT

  • Physical Therapist
  • Greensboro, NC
National Provider Identifier
1619930740
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9714 Issued in NC
Practice address
3200 Northline Ave
Ste 160
Greensboro, NC 27408-7616
Phone
(336) 545-5000
Fax
(336) 545-5020
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9714 NC Primary

Addresses

Primary practice location

3200 Northline Ave
Ste 160
Greensboro, NC 27408-7616

Mailing address

PO Box 38008
Greensboro, NC 27438-8008
Phone (336) 545-5000

Other practice location 1

4430 US Highway 220 N
Summerfield, NC 27358-9420
Phone (336) 545-5000

Other identifiers 5

IdentifierTypeStateIssuer
079UAOtherNCBCBS
7212246MedicaidNC
P00401782OtherNCMEDICARE RAILROAD
250087AOtherNCMEDICARE PTAN
198206OtherNCMEDCOST

Other names 1

  • Angela F Capilupo Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070810000257 NC Practitioner - Physical Therapist in Private Practice 2365533908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

120 William Penn PLZ
Durham, NC 27704-2150
Phone (919) 220-5255

Merit-based Incentive Payment System (MIPS)

Final score
89.07 of 100Reported as group
Quality
85.94
Promoting interoperability
100
Improvement activities
40
Cost
77.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9714NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA CurrentSince Jan 1, 2019 Accepting new patients
Emergeortho PA Physical Therapist CurrentSince Jan 1, 2019 Accepting new patients

Locations

120 William Penn Plz
Durham, NC 27704
Phone (919) 281-1836

3200 Northline Ave
Ste 200
Greensboro, NC 27408
Phone (336) 544-3905

3200 Northline Ave
Ste 160
Greensboro, NC 27408
Phone (336) 545-3530

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

4430 US Highway 220 N
Summerfield, NC 27358
Phone (336) 545-5002

Interoperability endpoints

  • Direct secure messaging: angela.capilupo.1@847.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1619930740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38008",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274388008",
            "telephone_number": "336-545-5000",
            "fax_number": "336-545-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 NORTHLINE AVE",
            "address_2": "STE 160",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087616",
            "telephone_number": "336-545-5000",
            "fax_number": "336-545-5020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4430 US Highway 220 N",
            "address_purpose": "LOCATION",
            "city": "Summerfield",
            "state": "NC",
            "postal_code": "273589420",
            "country_code": "US",
            "telephone_number": "336-545-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBERT",
        "first_name": "ANGELA",
        "middle_name": "FANELLA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "9714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "079UA",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7212246",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00401782",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "250087A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "198206",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "CAPILUPO",
            "middle_name": "F",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.