NPIMap

Individual provider Active NPI

Angelo C Arcilla, MEDICAL DOCTOR

  • Family Medicine Physician
  • Daly City, CA
National Provider Identifier
1821093394
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A048557 Issued in CA
Practice address
1800 Sullivan Ave
RM 101
Daly City, CA 94015-2227
Phone
(650) 994-0459
Fax
(650) 994-1450
NPI assigned
Jun 20, 2005
Reactivated
Mar 28, 2006
Last updated
Jan 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A048557 CA Primary

Addresses

Primary practice location

1800 Sullivan Ave
RM 101
Daly City, CA 94015-2227

Mailing address

1800 Sullivan Ave
RM 101
Daly City, CA 94015-2227
Phone (650) 994-0459

Other identifiers 1

IdentifierTypeStateIssuer
00A485572MedicaidCA

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
I20041104000435 CA Practitioner - General Practice 0042272742 Practice locations: Daly City, CA

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1800 Sullivan Ave
RM 101
Daly City, CA 94015-2227

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48557CAMDGeneral Practice Dentistry
A048557CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Angelo C Arcilla Medical Group Inc Family Medicine PastSince Oct 1, 2003 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: aarcilla223769@hpmg.direct-ci.net

Organizations & group practices 1

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1821093394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 SULLIVAN AVE",
            "address_2": "RM 101",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152227",
            "telephone_number": "650-994-0459",
            "fax_number": "650-994-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SULLIVAN AVE",
            "address_2": "RM 101",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152227",
            "telephone_number": "650-994-0459",
            "fax_number": "650-994-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCILLA",
        "first_name": "ANGELO",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MEDICAL DOCTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2010-01-26",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A048557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A485572",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.