Individual provider Active NPI

Angelo Mancuso, DO

  • Procedural Dermatology Physician
  • Madison, AL
National Provider Identifier
1992777627
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
DO-196 Issued in AL
Practice address
540 Hughes Rd
Madison, AL 35758-8959
Phone
(256) 772-9996
Fax
(256) 772-0294
NPI assigned
Feb 6, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X DO-196 AL Primary

Addresses

Primary practice location

540 Hughes Rd
Madison, AL 35758-8959

Mailing address

2828 Highway 31 S
Decatur, AL 35603-1538
Phone (256) 351-9077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20090416000238 AL Practitioner - Dermatology 3375556319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Philadelphia College of Osteopathic Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2828 Hwy 31 S
Suite 105
Decatur, AL 35603-1538
Phone (256) 351-9077

2828 Hwy 31 S 105
Decatur, AL 35603-1538

540 Hughes Rd
Madison, AL 35758-8999
Phone (256) 772-9996

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions658
Removal of skin cancer16
Removal or shaving of skin growth812
Skin biopsy420

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-196ALMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Dermatology Center, PC CurrentSince Apr 2, 1993 Accepting new patients

Locations

2828 Highway 31 S
Ste 105
Decatur, AL 35603
Phone (256) 351-9077

540 Hughes Rd
Madison, AL 35758
Phone (256) 631-7898

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 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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1992777627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 HIGHWAY 31 S",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031538",
            "telephone_number": "256-351-9077",
            "fax_number": "256-351-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 HUGHES RD",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588959",
            "telephone_number": "256-772-9996",
            "fax_number": "256-772-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCUSO",
        "first_name": "ANGELO",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AL",
            "license": "DO-196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.