Individual provider Active NPI

Vanessa D'Angelo, NP-C

  • Nurse Practitioner
  • Youngstown, OH
National Provider Identifier
1649887142
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.0027601 Issued in OH
Practice address
987 Boardman Canfield Rd
Youngstown, OH 44512-4222
Phone
(330) 965-8760
NPI assigned
Sep 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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 APRN.CNP.0027601 OH Primary

Addresses

Primary practice location

987 Boardman Canfield Rd
Youngstown, OH 44512-4222

Mailing address

7138 Oak Dr
Poland, OH 44514-3766
Phone (330) 206-6215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20210712001999 OH Practitioner - Nurse Practitioner 9133521271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optima Dermatology LLCGroup PAC ID 3971561648, 74 clinicians

Practice addresses (Care Compare)

987 Boardman Canfield Rd
Boardman, OH 44512-4222
Phone (330) 965-8760

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0027601OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optima Dermatology LLC CurrentSince May 1, 2021 Accepting new patients
Advanced Dermatology and Skin Cancer Center Past Accepting new patients

Locations

2525 E State St
Salem, OH 44460
Phone (330) 271-8614

987 Boardman Canfield Rd
Youngstown, OH 44512
Phone (330) 271-8589

Interoperability endpoints

  • Direct secure messaging: vdangelo@advdermatology.emadirect.md
  • Direct secure messaging: vdangelo638168@ehrdirect.uhhospitals.org

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": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1649887142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7138 OAK DR",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143766",
            "telephone_number": "330-206-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "987 BOARDMAN CANFIELD RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445124222",
            "telephone_number": "330-965-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ANGELO",
        "first_name": "VANESSA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0027601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.