NPIMap

Individual provider Active NPI

Angela Weaver Aboutanos, MD

  • Internal Medicine Physician
  • Melbourne, FL
National Provider Identifier
1730158577
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME75529 Issued in FL
Practice address
2222 S Harbor City Blvd
Suite 430
Melbourne, FL 32901-5594
Phone
(321) 541-1777
Fax
(321) 725-5504
NPI assigned
Mar 15, 2006
Last updated
Sep 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME75529 FL Primary

Addresses

Primary practice location

2222 S Harbor City Blvd
Suite 430
Melbourne, FL 32901-5594

Mailing address

2222 S Harbor City Blvd
Melbourne, FL 32901-5594
Phone (321) 541-1777

Other identifiers 2

IdentifierTypeStateIssuer
373042500MedicaidFL
110171606OtherFLRAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100218000845 FL Practitioner - Internal Medicine 2668516386 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Emory University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
RHG of Florida PAGroup PAC ID 7416479761, 22 clinicians
Steward Medical Group IncGroup PAC ID 2860688728, 23 clinicians
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

240 N Wickham Rd
204 Melbourne Family Med and Pediatrics
Melbourne, FL 32935-8660
Phone (321) 775-1300

240 N Wickham Rd
Suite 300
Melbourne, FL 32935-8661
Phone (321) 752-1588

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME75529FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc. Internal Medicine CurrentSince May 1, 2017 Accepting new patients
Steward Medical Group, Inc CurrentSince May 1, 2017 Accepting new patients
RHG of Florida PA CurrentSince Jan 16, 2025 Accepting new patients
Osler Medical Inc Past Accepting new patients

Locations

2222 S Harbor City Blvd
Ste 420
Melbourne, FL 32901
Phone (321) 768-9914

2222 S Harbor City Blvd
Ste 430
Melbourne, FL 32901
Phone (321) 344-8746

240 N Wickham Rd
Ste 204
Melbourne, FL 32935
Phone (321) 751-1801

240 N Wickham Rd
Ste 300
Melbourne, FL 32935
Phone (321) 752-1588

240 N Wickham Rd
Ste 304
Melbourne, FL 32935
Phone (321) 308-5050

8000 Ron Beatty Blvd
Ste A-3
Sebastian, FL 32976
Phone (772) 664-1388

Interoperability endpoints

  • Direct secure messaging: angela.aboutanos.1@15594.direct.athenahealth.com

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

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1730158577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 S HARBOR CITY BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329015594",
            "telephone_number": "321-541-1777",
            "fax_number": "321-725-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 S HARBOR CITY BLVD",
            "address_2": "SUITE 430",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329015594",
            "telephone_number": "321-541-1777",
            "fax_number": "321-725-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOUTANOS",
        "first_name": "ANGELA",
        "middle_name": "WEAVER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME75529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373042500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "110171606",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.