Labrene Tangalos, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601009850 Issued in MI

Practice address

51850 Dequindre Rd
Shelby Township, MI 48316-2806

Phone

(586) 799-4082

NPI assigned

Feb 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Express Med Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Southfield, MI
  • NPI 1649755125
  Medicare reassignment

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1851924807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51850 DEQUINDRE RD",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483162806",
            "telephone_number": "586-799-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51850 DEQUINDRE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483162806",
            "telephone_number": "586-799-4082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "929 Cambridge Rd",
            "address_purpose": "LOCATION",
            "city": "Berkley",
            "state": "MI",
            "postal_code": "480721933",
            "country_code": "US",
            "telephone_number": "586-255-8868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANGALOS",
        "first_name": "LABRENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leo M Szalma, LLP PSYCHOLOGIST
• Danielle Szokola
• Frank Talbot
• Nora E Tandy
• Evan Tangalos, DDS
• Steven M Taormina, D.O.
• Marvin M. Taragin, D.D.S
• Ionee Tarriman
• Kenesha Taylor, LPC
• Kalen Tchorzynski

• Physician Assistant in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.