Individual provider Active NPI

Aspen L Dangelo, PA

  • Physician Assistant
  • Binghamton, NY
National Provider Identifier
1679596076
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
040407 Issued in NY
Practice address
161 Riverside Dr
Suite 302
Binghamton, NY 13905-4176
Phone
(607) 798-1842
Fax
(607) 729-0147
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 040407 NY Primary

Addresses

Primary practice location

161 Riverside Dr
Suite 302
Binghamton, NY 13905-4176

Mailing address

161 Riverside Dr
Suite 302
Binghamton, NY 13905-4176
Phone (607) 798-1842

Other identifiers 1

IdentifierTypeStateIssuer
02666411MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050406000945 NY Practitioner - Physician Assistant 2062469547 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

40 Mitchell Ave
Binghamton, NY 13903-1678
Phone (607) 772-0639

54 Main St
Candor, NY 13743-1619
Phone (607) 659-7272

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
040407NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital Inc. CurrentSince Oct 1, 2022 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. Physician Assistant Current Accepting new patients
United Medical Associates PC CurrentSince May 5, 2025 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince May 5, 2025 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Oct 1, 2022 Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

161 Riverside Dr
Ste 302
Binghamton, NY 13905
Phone (607) 798-1842

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

240 Riverside Dr
Johnson City, NY 13790
Phone (607) 754-3863

Interoperability endpoints

  • Direct secure messaging: adangelo196791@direct-guthrie.org

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1679596076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 RIVERSIDE DR",
            "address_2": "SUITE 302",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054176",
            "telephone_number": "607-798-1842",
            "fax_number": "607-729-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 RIVERSIDE DR",
            "address_2": "SUITE 302",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054176",
            "telephone_number": "607-798-1842",
            "fax_number": "607-729-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANGELO",
        "first_name": "ASPEN",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "040407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02666411",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.