Active NPI
Angelicum Medical Services PC
- Family Medicine Physician
- Bronx, NY
National Provider Identifier
1659692812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 271367-1
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02061425 | Medicaid | NY | |
| 03302870 | Medicaid | NY |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Bronx, NY
- NPI 1790036010
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.