Individual provider Active NPI

Angela Brooke Ingle, NP

  • Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1629765581
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95020916 Issued in CA
Practice address
2425 Samaritan Dr
San Jose, CA 95124-3908
Phone
(408) 559-2011
NPI assigned
Apr 20, 2023
Last updated
May 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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 95020916 CA Primary

Addresses

Primary practice location

2425 Samaritan Dr
San Jose, CA 95124-3908

Mailing address

PO Box 743111
Atlanta, GA 30374-3111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231121002023 CA Practitioner - Nurse Practitioner 7012365679 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden State Providers, a Medical CorporationGroup PAC ID 7012212475, 23 clinicians

Practice addresses (Care Compare)

2425 Samaritan Dr
San Jose, CA 95124-3908
Phone (408) 559-2588

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95020916CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Providers, a Medical Corporation CurrentSince Jun 3, 2024 Accepting new patients
Acute Care Surgery Medical Group, Inc. CurrentSince Oct 1, 2023 Accepting new patients

Locations

4510 Brockton Ave
Ste 175
Riverside, CA 92501
Phone (951) 786-5100

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

150 N Jackson Ave
Ste 100
San Jose, CA 95116
Phone (408) 769-5340

225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051

2425 Samaritan Dr
San Jose, CA 95124
Phone (408) 354-2114

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: angela.ingle@hca3.eclinicaldirectplus.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, 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": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1629765581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743111",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243908",
            "telephone_number": "408-559-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGLE",
        "first_name": "ANGELA",
        "middle_name": "BROOKE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-20",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95020916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.