Carmichael Angeles, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

2255725 Issued in NY

Practice address

2500 Route 347
BLDG 14a
Stony Brook, NY 11790-2554

Phone

(631) 689-7800

NPI assigned

Jun 30, 2005

Last updated

Jan 3, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eagle Butte Indian Health Service Hospital

  • Public Health or Welfare Agency
  • Eagle Butte, SD
  • NPI 1558395848

  TX

  Medicare reassignment NPD
• Quentin N Burdick Comprehensive Health Care Facility

  • Rural Acute Care Hospital
  • Belcourt, ND
  • NPI 1952346934

  TX

  Medicare reassignment NPD
• North Shore Hematology Oncology Associates PC

  • Specialist
  • Port Jefferson Station, NY
  • NPI 1396794574
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1689671190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ROUTE 347",
            "address_2": "BLDG 14A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902554",
            "telephone_number": "631-689-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ROUTE 347",
            "address_2": "BLDG 14A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902554",
            "telephone_number": "631-689-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELES",
        "first_name": "CARMICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "2255725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02410768",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "148301",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00073812",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUECROSS BLUESHIE",
            "identifier": "6X8591",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2949859",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Kenneth Anderson, MD
• Wesam F Andraous, MD
• Donna Andricopoulos
• Anna Andrzejczyk
• Sophie Anfang, MD
• Jaclyn Angielczyk, MD
• Athanasios Angistriotis, MD
• David Anolik, DDS
• Robert K. Ansbach, R.P.A.-C
• Shana Anthony, DPT

• Nephrology Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.