Individual provider Active NPI

Angela Michelle Laney, PA-C

  • Surgical Physician Assistant
  • Lakewood, WA
National Provider Identifier
1700388196
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60903290 Issued in WA
Practice address
7308 Bridgeport Way W Ste 201
Lakewood, WA 98499
Phone
(253) 582-7257
Fax
(253) 582-1617
NPI assigned
Mar 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA60903290 WA Primary

Addresses

Primary practice location

7308 Bridgeport Way W Ste 201
Lakewood, WA 98499

Mailing address

7308 Bridgeport Way W Ste 201
Lakewood, WA 98499-8000
Phone (253) 582-7257

Other practice location 1

4311 11th Ave NE Ste 200
Seattle, WA 98105-6367
Phone (206) 616-4001

Other practice location 2

1724 W Union Ave Ste 100
Tacoma, WA 98405-2099
Phone (253) 830-5200

Other practice location 3

2727 Hollycroft St
Gig Harbor, WA 98335-1305
Phone (253) 358-4002

Other names 1

  • Angela Michelle Deloach Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20190214000458 WA Practitioner - Physician Assistant 1456699677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

1401 S Laventure Rd
Mount Vernon, WA 98274-6033
Phone (360) 424-2400

1724 W Union Ave
Tacoma, WA 98405-2099
Phone (253) 830-5200

2727 Hollycroft St
Suite 410
Gig Harbor, WA 98335-1369
Phone (253) 582-7257

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60903290WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons, Inc., P.S. Surgical CurrentSince Nov 27, 2018 Accepting new patients
Proliance Surgeons Inc P S Surgical CurrentSince Nov 27, 2018 Accepting new patients
Vitreoretinal Associates PLLC Past Accepting new patients

Locations

7308 Bridgeport Way W
Ste 201
Lakewood, WA 98499
Phone (253) 582-7257

1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

1724 West Union Ave
Ste 100
Tacoma, WA 98405
Phone (253) 830-5200

Interoperability endpoints

  • Direct secure messaging: alaney13265@fhsce.catholichealth.net
  • Direct secure messaging: angela.laney.p73@direct.proliance.nextgenshare.com

Organizations & group practices 4

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 5

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": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1700388196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7308 BRIDGEPORT WAY W STE 201",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998000",
            "telephone_number": "253-582-7257",
            "fax_number": "253-582-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7308 BRIDGEPORT WAY W STE 201",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98499",
            "telephone_number": "253-582-7257",
            "fax_number": "253-582-1617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4311 11th Ave NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056367",
            "country_code": "US",
            "telephone_number": "206-616-4001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1724 W Union Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984052099",
            "country_code": "US",
            "telephone_number": "253-830-5200",
            "fax_number": "253-751-1160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2727 Hollycroft St",
            "address_purpose": "LOCATION",
            "city": "Gig Harbor",
            "state": "WA",
            "postal_code": "983351305",
            "country_code": "US",
            "telephone_number": "253-358-4002",
            "fax_number": "253-358-4015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANEY",
        "first_name": "ANGELA",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-01",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60903290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "DELOACH",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.