Individual provider Active NPI

Joseph Michael Angelo, PA

  • Medical Physician Assistant
  • Shreveport, LA
National Provider Identifier
1992831895
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.A10405 Issued in LA
Practice address
7925 Youree Dr Ste 200
Shreveport, LA 71105-5134
Phone
(318) 212-3610
Fax
(318) 212-3709
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA.A10405 LA Primary

Addresses

Primary practice location

7925 Youree Dr Ste 200
Shreveport, LA 71105-5134

Mailing address

7925 Youree Dr Ste 200
Shreveport, LA 71105-5134
Phone (318) 212-3610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20090401000201 LA Practitioner - Physician Assistant 8426045089 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Orthopedic Clinic 21 clinicians
Cornerstone Therapy and Balance Center, LLC 98 clinicians

Practice addresses (Care Compare)

1202 Louisiana Ave
Shreveport, LA 71101-3910

244 Peregrine Way
Bossier City, LA 71112-2556

7925 Youree Dr
Suite 200
Shreveport, LA 71105-5134
Phone (318) 212-3610

8961 Youree Dr
Shreveport, LA 71115-3001
Phone (318) 671-8772

Hospital & facility affiliations

  • Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.A10405LAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arklatex Medical Consultants a Medical Corporation CurrentSince Aug 15, 2022 Accepting new patients
Arklatex Medical Consultants a Medical Corporation Physician Assistant CurrentSince Aug 15, 2022 Accepting new patients
Radiology Imaging Associates, LLP Past Accepting new patients
J Scott Bicknell MD and Willis-Knighton Medical Center PastSince Jan 1, 1990 Accepting new patients
Musculoskeletal Institute of Louisiana, LLC PastSince Jan 1, 1990 Accepting new patients

Locations

8731 Park Plaza Dr
Shreveport, LA 71105
Phone (318) 524-7144

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BCHDDD

Organizations & group practices 8

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 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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1992831895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7925 YOUREE DR STE 200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055134",
            "telephone_number": "318-212-3610",
            "fax_number": "318-212-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7925 YOUREE DR STE 200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055134",
            "telephone_number": "318-212-3610",
            "fax_number": "318-212-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELO",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "PA.A10405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.