Individual provider Active NPI

Angela Renea Trodglen, APRN

  • Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1629533674
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11001219 Issued in FL
Practice address
1801 SE Hillmoor Dr Ste C-207
Port St Lucie, FL 34952-7574
Phone
(772) 335-4234
Fax
(772) 335-4236
NPI assigned
Feb 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11001219 FL Primary

Addresses

Primary practice location

1801 SE Hillmoor Dr Ste C-207
Port St Lucie, FL 34952-7574

Mailing address

2206 11TH LN
Vero Beach, FL 32960-3935
Phone (772) 643-8712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190417000893 FL Practitioner - Nurse Practitioner 3072854272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Infectious DiseasesGroup PAC ID 4486689957, 18 clinicians

Practice addresses (Care Compare)

1801 SE Hillmoor Dr
Suite C 207
Port St Lucie, FL 34952-7574
Phone (772) 335-4234

Hospital & facility affiliations

  • HCA Florida Lawnwood Hospital Hospital, Fort Pierce, FL, CCN 100246
  • St Lucie Medical Center Hospital, Port Saint Lucie, FL, CCN 100260

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Infectious Diseases CurrentSince Mar 1, 2019 Accepting new patients

Locations

356 E Midway Rd
Fort Pierce, FL 34982
Phone (772) 464-9746

1801 SE Hillmoor Dr
Ste C-207
Port St Lucie, FL 34952
Phone (772) 335-4234

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.

Hospital & facility affiliations 2

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": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1629533674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 11TH LN",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329603935",
            "telephone_number": "772-643-8712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DR STE C-207",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527574",
            "telephone_number": "772-335-4234",
            "fax_number": "772-335-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRODGLEN",
        "first_name": "ANGELA",
        "middle_name": "RENEA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11001219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.