Individual provider Active NPI

Alexandra Christine D'Angelo, D.O.

  • Family Medicine Physician
  • Hamburg, NY
National Provider Identifier
1952747974
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
280597 Issued in NY
Practice address
4855 Camp Rd
Suite 100
Hamburg, NY 14075-2600
Phone
(716) 646-1084
Fax
(716) 646-0763
NPI assigned
May 16, 2013
Last updated
Mar 21, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 280597 NY Primary

Addresses

Primary practice location

4855 Camp Rd
Suite 100
Hamburg, NY 14075-2600

Mailing address

PO Box 798
Hamburg, NY 14075-0798

Other identifiers 1

IdentifierTypeStateIssuer
04503013MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160823000922 NY Practitioner - Family Practice 7719272285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Primary Care Associates, LLPGroup PAC ID 9931013703, 13 clinicians

Practice addresses (Care Compare)

4855 Camp Rd
Suite 100
Hamburg, NY 14075-2600
Phone (716) 646-1084

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
280597NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Primary Care Associates LLP Family Medicine CurrentSince Aug 1, 2016 Accepting new patients

Locations

4855 Camp Rd
Ste 100
Hamburg, NY 14075
Phone (716) 646-1084

Interoperability endpoints

  • Direct secure messaging: adangelo@lakeshorepca.medentdirect.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1952747974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 798",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140750798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 CAMP RD",
            "address_2": "SUITE 100",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140752600",
            "telephone_number": "716-646-1084",
            "fax_number": "716-646-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ANGELO",
        "first_name": "ALEXANDRA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-16",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "280597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04503013",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

Verify at the official NPI Registry.