Active NPI
Edward J. Deangelo, M.D.
- Diagnostic Radiology Physician
- Worcester, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 226392
- Practice address
- 281 Lincoln St
Medical Staff SVCS
Worcester, MA 01605-2138 - Phone
- (508) 334-1131
- Fax
- (508) 334-8235
- NPI assigned
- Jan 3, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | DR.0075633 | CO | |
| Diagnostic Radiology Physician | 2085R0202X | 226392 | MA | Primary |
Addresses
Primary practice location
281 Lincoln St
Medical Staff SVCS
Worcester, MA 01605-2138
Mailing address
281 Lincoln St
Medical Staff SVCS
Worcester, MA 01605-2138
Phone (508) 334-1131
Other practice location 1
10350 E Dakota Ave
Denver, CO 80247-1314
Phone (303) 338-4545
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Connecticut School of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10350 E Dakota Ave
Kaiser Permanente Regional Office
Denver, CO 80247-1314
Phone (303) 338-4545
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0075633 | CO | MD | Diagnostic Radiology Physician |
| 226392 | MA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colorado Permanente Medical Group, P.C. | Diagnostic Radiology | Current | Accepting new patients |
| Bald Hill Pediatrics | Past | Accepting new patients | |
| Umass Memorial Medical Group Inc | Past | Accepting new patients |
Locations
10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350
10350 E Dakota Ave
Ofc
Denver, CO 80247
Phone (303) 344-7771
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Denver, CO
- NPI 1760599724
Diagnostic Radiology
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1760445373
-
- Pediatrics Physician
- Warwick, RI
- NPI 1649206277
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749427200000",
"number": "1952468514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "281 LINCOLN ST",
"address_2": "MEDICAL STAFF SVCS",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052138",
"telephone_number": "508-334-1131",
"fax_number": "508-334-8235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "281 LINCOLN ST",
"address_2": "MEDICAL STAFF SVCS",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052138",
"telephone_number": "508-334-1131",
"fax_number": "508-334-8235"
}
],
"practiceLocations": [
{
"address_1": "10350 E Dakota Ave",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802471314",
"country_code": "US",
"telephone_number": "303-338-4545",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEANGELO",
"first_name": "EDWARD",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2025-06-09",
"certification_date": "2025-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CO",
"license": "DR.0075633",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "226392",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "10350 E Dakota Ave",
"city": "Denver",
"state": "CO",
"country_code": "US",
"postal_code": "802471314",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.