Active NPI
Wayne Angeloty
- Physical Therapist
- Fremont, CA
National Provider Identifier
1801937446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT10247
- Practice address
- 39210 State St
Suite 117
Fremont, CA 94538-1456 - Phone
- (510) 791-0898
- Fax
- (510) 494-4964
- NPI assigned
- Feb 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT10247 | CA | Primary |
Addresses
Primary practice location
39210 State St
Suite 117
Fremont, CA 94538-1456
Mailing address
39210 State St
Suite 117
Fremont, CA 94538-1456
Phone (510) 791-0898
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT10247 | Other | CA | LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT10247 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1801937446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39210 STATE ST",
"address_2": "SUITE 117",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381456",
"telephone_number": "510-791-0898",
"fax_number": "510-494-4964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39210 STATE ST",
"address_2": "SUITE 117",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381456",
"telephone_number": "510-791-0898",
"fax_number": "510-494-4964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANGELOTY",
"first_name": "WAYNE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-08",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT10247",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "PT10247",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.