Active NPI
Mario G Angulo, DO
- Family Medicine Physician
- Freehold, NJ
National Provider Identifier
1942791827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 25MB10963600
- Practice address
- 901 W Main St Ste 305B
Freehold, NJ 07728-2537 - Phone
- (732) 577-0600
- Fax
- (732) 577-6332
- NPI assigned
- May 25, 2018
- Last updated
- Oct 13, 2022
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25MB10963600 | NJ | Primary |
Addresses
Primary practice location
901 W Main St Ste 305B
Freehold, NJ 07728-2537
Mailing address
PO Box 416457
Boston, MA 02241-6457
Phone (844) 362-1735
Other practice location 1
744 Broadway
Bayonne, NJ 07002-3989
Phone (201) 858-4110
Other practice location 2
176 Palisade Ave
Jersey City, NJ 07306-1121
Phone (201) 795-8201
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MB10963600 | NJ | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665619200000",
"number": "1942791827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 416457",
"city": "BOSTON",
"state": "MA",
"postal_code": "022416457",
"telephone_number": "844-362-1735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 W MAIN ST STE 305B",
"city": "FREEHOLD",
"state": "NJ",
"postal_code": "077282537",
"telephone_number": "732-577-0600",
"fax_number": "732-577-6332"
}
],
"practiceLocations": [
{
"address_1": "744 Broadway",
"address_purpose": "LOCATION",
"city": "Bayonne",
"state": "NJ",
"postal_code": "070023989",
"country_code": "US",
"telephone_number": "201-858-4110",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "176 Palisade Ave",
"address_purpose": "LOCATION",
"city": "Jersey City",
"state": "NJ",
"postal_code": "073061121",
"country_code": "US",
"telephone_number": "201-795-8201",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANGULO",
"first_name": "MARIO",
"middle_name": "G",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-25",
"last_updated": "2022-10-13",
"certification_date": "2022-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NJ",
"license": "25MB10963600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Freehold, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.