Individual provider Active NPI

Michael Edward Angeline, M.D.

  • Orthopaedic Surgery Physician
  • Rock Hill, NY
National Provider Identifier
1780830158
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
260171 Issued in NY
Practice address
61 Emerald PL
Rock Hill, NY 12775-6049
NPI assigned
Aug 17, 2008
Last updated
Apr 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 260171 NY Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 260171 NY

Addresses

Primary practice location

61 Emerald PL
Rock Hill, NY 12775-6049

Mailing address

155 Crystal Run Rd
Middletown, NY 10941-4028
Phone (845) 703-6999

Other identifiers 1

IdentifierTypeStateIssuer
1780830158MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121012000261 WI Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 9830348556 Reassigns benefits to 1 organization
I20240216000682 NY Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 9830348556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Georgetown University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 Crystal Run Rd
Middletown, NY 10941-4069
Phone (845) 692-6999

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)61

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation Current Accepting new patients
Crystal Run Healthcare Physicians LLP CurrentSince Jan 8, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Aug 20, 2012 Accepting new patients
Mercy Health System Corporation CurrentSince Aug 20, 2012 Accepting new patients
Crystal Run Healthcare Physicians LLP CurrentSince Jan 8, 2024 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

155 Crystal Run Rd
Middletown, NY 10941

300 Crystal Run Rd
Middletown, NY 10941
Phone (845) 692-6999

61 Emerald Pl
Rock Hill, NY 12775
Phone (845) 703-8999

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

3524 E Milwaukee St
Janesville, WI 53546
Phone (608) 756-7100

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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 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": "1218931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1780830158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 EMERALD PL",
            "city": "ROCK HILL",
            "state": "NY",
            "postal_code": "127756049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELINE",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-17",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "260171",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "260171",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780830158",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, NY

Sources for this page

Verify at the official NPI Registry.