Angelique M Stake, ARNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

APRN9214698 Issued in FL

Practice address

3978 W Hillsborough Ave Unit 21B
Tampa, FL 33614-5628

Phone

(813) 906-1412

Fax

(813) 413-1971

NPI assigned

Oct 5, 2010

Sex

Female

Sole proprietor

No

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.

• Access Medical Group of Tampa II, LLC.

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1841700697

  Family Medicine, FL

  Medicare reassignment NPD

Medicare fee-for-service enrollment

Enrolled in FL

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

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angelique.stake@cmg.eclinicaldirectplus.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 10, 2021.

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1902115165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 BLUE LAGOON DR STE 365",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331267010",
            "telephone_number": "786-322-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3978 W HILLSBOROUGH AVE UNIT 21B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336145628",
            "telephone_number": "813-906-1412",
            "fax_number": "813-413-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAKE",
        "first_name": "ANGELIQUE",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2021-03-10",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9214698",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "APRN9214698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "angelique.stake@cmg.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "health information has changed",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "3978 W Hillsborough Ave Unit 21B",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336145628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tazia K. Stagg, M.D., M.P.H.
• Mason Staggs, PT, DPT
• Angela Patrice Stagliano
• Kathleen Stahl, MSW
• Christina Stair
• Jithin Jai Stalan
• Monica Elizabeth Staley, PA-C
• Jacqueline Stalker, BCBA, LBA
• Ricki L Stallard
• Dexter G Stallworth, MD

• All providers in Tampa, FL
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.