Individual provider Active NPI

Anthony Deangelis III, PHARMD

  • Pharmacist
  • Dublin, OH
National Provider Identifier
1669075545
Registry record updated Nov 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS63620 Issued in FL
Practice address
655 Metro PL S Ste 450
Dublin, OH 43017-3388
Phone
(800) 968-6962
NPI assigned
Nov 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 06131 RI
Pharmacist 183500000X PS63620 FL Primary

Addresses

Primary practice location

655 Metro PL S Ste 450
Dublin, OH 43017-3388

Mailing address

11060 Balfour St
Venice, FL 34293-4704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS63620FLMDPharmacist
06131RIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island CVS Pharmacy, L.L.C. PastSince Nov 1, 2020 Accepting new patients
Rhode Island CVS Pharmacy LLC PastSince Nov 1, 2020 Accepting new patients

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": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667692800000",
    "number": "1669075545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11060 BALFOUR ST",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342934704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 METRO PL S STE 450",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430173388",
            "telephone_number": "800-968-6962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELIS",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2022-11-06",
        "certification_date": "2022-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "RI",
            "license": "06131",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS63620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2022; 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.