Angela M Northcutt, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

10003396A Issued in IN

Practice address

123 S Franklin Rd
Bloomington, IN 47404-5296

Phone

(812) 778-3116

Fax

(812) 778-3117

NPI assigned

Jun 30, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Physician Assistant

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Urgent Care Professionals PLLCGroup PAC ID 9830437946, 36 clinicians

Comprehensive Rehab Consultants PLLCGroup PAC ID 6800220682, 251 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anorthcutt@direct.uspi.com

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.

• Comprehensive Rehab Consultants PLLC

  • Physical Medicine & Rehabilitation Physician
  • Middle River, MD
  • NPI 1710529771

  IN

  Medicare reassignment Care Compare group NPD
• Illinois Urgent Care Professionals PLLC

  • Family Medicine Physician
  • Homewood, IL
  • NPI 1215407812

  IN

  Medicare reassignment Care Compare group
• Pic Indiana PC

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1942546890
  Medicare reassignment

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1740287119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 S FRANKLIN RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474045296",
            "telephone_number": "812-778-3116",
            "fax_number": "812-778-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S FRANKLIN RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474045296",
            "telephone_number": "812-778-3116",
            "fax_number": "812-778-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHCUTT",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MN",
            "license": "9948",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WV",
            "license": "1612-023",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA04880",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10003396A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "8N9563",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42865500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "559168600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cory Lee Norman, MD
• Lillian Grace Norris
• Sarah Elizabeth Norris, DO
• Suzette Danielle Norris
• North Star Nutrition Counseling , LLC
• David R Northcutt, D.P.M.
• Northern Indiana Emergency Physicians, LLP
• Northwest Hospitalist Physicians, LLP
• Rachael D Norton, MS, OTR, LDRS
• Ariel Hannah Nosofsky

• Surgical Physician Assistant in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Surgical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.