Organization Active NPI

Angelicum Medical Services PC

  • Family Medicine Physician
  • Bronx, NY
National Provider Identifier
1659692812
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
271367-1 Issued in NY
Legal business name
ANGELICUM MEDICAL SERVICES PC
Practice address
334 Grand Concourse
Bronx, NY 10451-5409
Phone
(718) 590-5900
Fax
(888) 557-5258
NPI assigned
Jun 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Authorized official

Name
Alexander Baldonado, MD
Title
President
Phone
(347) 825-8288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 271367-1 NY Primary

Addresses

Primary practice location

334 Grand Concourse
Bronx, NY 10451-5409

Mailing address

334 Grand Concourse
Bronx, NY 10451-5409
Phone (718) 590-5900

Other identifiers 2

IdentifierTypeStateIssuer
02061425MedicaidNY
03302870MedicaidNY

National Provider Directory

National Provider Directory

Locations

570 Melrose Ave
Bronx, NY 10455
Phone (718) 585-9200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436400000000",
    "number": "1659692812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515409",
            "telephone_number": "718-590-5900",
            "fax_number": "888-557-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515409",
            "telephone_number": "718-590-5900",
            "fax_number": "888-557-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELICUM MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-22",
        "last_updated": "2015-07-09",
        "status": "A",
        "authorized_official_last_name": "BALDONADO",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-825-8288",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "271367-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02061425",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03302870",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.