Active NPI
Victor R Angeles, MD
- Neurology Physician
- Leitchfield, KY
National Provider Identifier
1922003532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 37612
- Practice address
- 908 Wallace Ave
Leitchfield, KY 42754-1479 - Phone
- (270) 230-0212
- Fax
- (270) 230-0104
- NPI assigned
- Jun 20, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 37612 | KY | Primary |
Addresses
Primary practice location
908 Wallace Ave
Leitchfield, KY 42754-1479
Mailing address
908 Wallace Ave
Leitchfield, KY 42754-1479
Phone (270) 230-0212
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64057722 | Medicaid | KY | |
| 000000333566 | Other | KY | ANTHEM |
| 2444879000 | Other | KY | PASSPORT ADVANTAGE |
| 50003444 | Other | KY | PASSPORT |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37612 | KY | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients | |
| Noel Z. Reloj,Sr, MD, PSC | Neurology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
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": "1328054400000",
"number": "1922003532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "908 WALLACE AVE",
"city": "LEITCHFIELD",
"state": "KY",
"postal_code": "427541479",
"telephone_number": "270-230-0212",
"fax_number": "270-230-0104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "908 WALLACE AVE",
"city": "LEITCHFIELD",
"state": "KY",
"postal_code": "427541479",
"telephone_number": "270-230-0212",
"fax_number": "270-230-0104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANGELES",
"first_name": "VICTOR",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-20",
"last_updated": "2012-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "KY",
"license": "37612",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64057722",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000333566",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT ADVANTAGE",
"identifier": "2444879000",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT",
"identifier": "50003444",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leitchfield, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.