Individual provider Active NPI

Angela Marie Mitchell, P.A.

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1700993961
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2970 Issued in FL
Practice address
5820 Buckingham Rd
Fort Myers, FL 33905-7413
Phone
(239) 694-2151
Fax
(239) 694-6772
NPI assigned
Aug 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PA2970 FL Primary

Addresses

Primary practice location

5820 Buckingham Rd
Fort Myers, FL 33905-7413

Mailing address

5820 Buckingham Rd
Fort Myers, FL 33905-7413
Phone (239) 694-2151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20211203000265 AZ Practitioner - Physician Assistant 4284706920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest HBP Medical Services LLCGroup PAC ID 8921356536, 278 clinicians

Practice addresses (Care Compare)

1551 E Tangerine Rd
Oro Valley, AZ 85755-6213
Phone (520) 229-2657

6200 N la Cholla Blvd
Tucson, AZ 85741-3529
Phone (520) 229-2657

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8816AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Missouri Inc Past Accepting new patients
Agency for Persons With Disabilities Past Accepting new patients
Oro Valley Hospital LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700993961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 BUCKINGHAM RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057413",
            "telephone_number": "239-694-2151",
            "fax_number": "239-694-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 BUCKINGHAM RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057413",
            "telephone_number": "239-694-2151",
            "fax_number": "239-694-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.