Orthopedic Sports Medicine of Manistee PLLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

ORTHOPEDIC SPORTS MEDICINE OF MANISTEE PLLC

Practice address

3234 County Line Rd W
Manistee, MI 49660-9519

Phone

(917) 545-0789

NPI assigned

Mar 5, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Mark Dangelo, DONPI 1730312240

Title

Physician

Phone

(917) 545-0789

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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

• Mark Salvatore Dangelo, D.O.

  • Orthopaedic Surgery Physician
  • Manistee, MI
  • NPI 1730312240
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1646438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646438400000",
    "number": "1689321010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3234 COUNTY LINE RD W",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609519",
            "telephone_number": "917-545-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3234 COUNTY LINE RD W",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609519",
            "telephone_number": "917-545-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC SPORTS MEDICINE OF MANISTEE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-05",
        "last_updated": "2022-03-05",
        "certification_date": "2022-03-05",
        "status": "A",
        "authorized_official_last_name": "DANGELO",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "917-545-0789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Imelda Oertel, LMSW
• Kyle Ohman
• Austin Andrew Olson
• Jenny Lyn Olson, RPH
• William Olson, PTA
• Geoffrey Roland Paine, D.D.S.
• Luanne Parks, NP
• Pathology Services.Org LLC
• Pathologyservices.Org LLC
• PDS I Michigan Inc

• Orthopaedic Surgery Physician in Manistee, MI
• Providers in Manistee, MI by specialty
• Orthopaedic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.