NPIMap

Individual provider Active NPI

Sydney Dangelo, DO

  • Internal Medicine Physician
  • La Mesa, CA
National Provider Identifier
1770141061
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A19333 Issued in CA
Practice address
8881 Fletcher Pkwy Ste 370
La Mesa, CA 91942-6103
Phone
(619) 462-5555
NPI assigned
May 31, 2019
Last updated
Mar 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 20A19333 CA Primary

Addresses

Primary practice location

8881 Fletcher Pkwy Ste 370
La Mesa, CA 91942-6103

Mailing address

8881 Fletcher Pkwy # 307
La Mesa, CA 91942-3134

Other practice location 1

7454 W Denaro Dr
Glendale, AZ 85308
Phone (619) 654-7241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220808000905 CA Practitioner - Internal Medicine 5597147538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Caring Physicians Medical Group, Inc.Group PAC ID 9335133446, 3 clinicians

Practice addresses (Care Compare)

8881 Fletcher Pkwy
Suite 370
La Mesa, CA 91942-6103
Phone (619) 462-5555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A19333CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Physicians Medical Group, Inc. Internal Medicine CurrentSince Jul 11, 2022 Accepting new patients
Christopher C. Bradley MD PHD, a Professional Corporation PastSince Mar 20, 2022 Accepting new patients

Locations

8881 Fletcher Pkwy
Ste 370
La Mesa, CA 91942
Phone (619) 258-4000

Interoperability endpoints

  • Direct secure messaging: sdangelo32387@sharphealthcare.direct-ci.com

Organizations & group practices 2

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 6

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": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1770141061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8881 FLETCHER PKWY # 307",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8881 FLETCHER PKWY STE 370",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919426103",
            "telephone_number": "619-462-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7454 W Denaro Dr",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "85308",
            "country_code": "US",
            "telephone_number": "619-654-7241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANGELO",
        "first_name": "SYDNEY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A19333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.