CMS-1500 Box 24J / 33a • NPI
1053379917
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
367500000X (CMS 43)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered
Box 32 Service Location & ZIP+4
995 MAR WALT DR, FORT WALTON BEACH, FL, 32547-6758
✓ 9-Digit EDI 837 ZIP+4 (32547-6758)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1053379917 (MICHAEL ANGELORO, CRNA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1053379917 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | MICHAEL ANGELORO, CRNA |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered NUCC Code: 367500000X (Nurse Anesthetist, Certified Registered) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 995 MAR WALT DR, FORT WALTON BEACH, FL, 32547-6758 |
| Practice Telephone / Fax | Tel: (850) 863-7887 |
| Administrative Mailing Address | 1405 WINDWARD LN, NICEVILLE, FL, 32578-4343 |
| Enumeration & Last Sync | Enumerated: 2006-05-02 | CMS Record Updated: 2011-05-30 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (367500000X)
What Does Taxonomy Code 367500000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 367500000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MICHAEL ANGELORO, CRNA)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
367500000X — Nurse Anesthetist, Certified RegisteredPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered | State: FL | License: ARNP3065242 | Primary: Yes (Primary) |
367500000X — Nurse Anesthetist, Certified RegisteredPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered | State: MA | License: 155292 | Primary: Secondary |
367500000X — Nurse Anesthetist, Certified RegisteredPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered | State: ME | License: 050542 | Primary: Secondary |
367500000X — Nurse Anesthetist, Certified RegisteredPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered | State: NH | License: 053324-23-11 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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