Individual provider Active NPI

Mary Angelle Cargill, NP

  • Nurse Practitioner
  • Vacaville, CA
National Provider Identifier
1922642784
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95011808 Issued in CA
Practice address
421 Nut Tree Rd
Vacaville, CA 95687-3508
Phone
(707) 646-5500
Fax
(707) 624-7501
NPI assigned
Nov 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95011808 CA
Nurse Practitioner 363L00000X NP95011808 CA Primary

Addresses

Primary practice location

421 Nut Tree Rd
Vacaville, CA 95687-3508

Mailing address

421 Nut Tree Rd
Vacaville, CA 95687-3508
Phone (707) 624-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20200204002696 CA Practitioner - Nurse Practitioner 1052747326 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northbay Health Medical FoundationGroup PAC ID 3274010871, 207 clinicians

Practice addresses (Care Compare)

1305 Stratford Ave
Dixon, CA 95620-2024
Phone (707) 646-5500

416 Napa Junction Rd
Suite 140
American Canyon, CA 94503-1281
Phone (707) 646-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95011808CAMDNurse Practitioner
NP95011808CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group CurrentSince Mar 25, 2025 Accepting new patients
Northbay Healthcare Group Current Accepting new patients
Northbay Health Medical Foundation CurrentSince Jan 1, 2026 Accepting new patients
Northbay Physicians Surgery Center LLC Past Accepting new patients

Locations

416 Napa Junction Rd
#140
American Canyon, CA 94503

1305 Stratford Ave
Dixon, CA 95620

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

421 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 455-3000

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

1679 E Monte Vista Ave
Ste 104
Vacaville, CA 95688
Phone (707) 624-7400

1010 Nut Tree Rd
Ste 100B
Vacaville, CA 95687
Phone (707) 646-7999

101 Main St
Winters, CA 95694
Phone (530) 795-4123

Interoperability endpoints

  • Direct secure messaging: mangellecargill196553@direct.renown.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/UMZ-Uxn6V9x08sH5gCnG-5yPg9ZX7et6/

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1922642784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 NUT TREE RD",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956873508",
            "telephone_number": "707-624-7500",
            "fax_number": "707-624-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 NUT TREE RD",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956873508",
            "telephone_number": "707-646-5500",
            "fax_number": "707-624-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARGILL",
        "first_name": "MARY",
        "middle_name": "ANGELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95011808",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95011808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

Verify at the official NPI Registry.