Dr. Carlos Manuel Angeles San Mateo
Surgery

Address: 99 Montecillo Rd, San Rafael, CA 94903
Phone: 4154442950

Dr. Carlos Manuel Angeles San Mateo (NPI# 1013159912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1013159912
Entity Type Individual
Full Name Dr. Carlos Manuel Angeles San Mateo
Credential MD
Gender Male
Practice Address 99 Montecillo Rd
San Rafael
CA 94903
Practice Telephone 4154442950
Mailing Address 99 Montecillo Rd
San Rafael
CA 94903-3308
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2009-03-24
Last Update Date 2018-06-05

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 208600000X Surgery Allopathic & Osteopathic Physicians ME125705 FL
No 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care
Yes 208600000X Surgery Allopathic & Osteopathic Physicians A137904 CA

Physician Overview

NPI 1013159912
PAC ID by PECOS 5294036000
Professional Enrollment ID I20180705001286
Full Name Carlos M A San Mateo
Organization Legal Name PERMANENTE MEDICAL GROUP INC
Phone Number 7076511000
Gender M
Medical School BOSTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year 2009
Primary Specialty COLORECTAL SURGERY (PROCTOLOGY)
Group Practice PAC ID 8921910225
Number of Group Practice Members 6917
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
050510 KAISER FOUNDATION HOSPITAL - SAN RAFAEL

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
PQRS_EP_130_1 Documentation of Current Medications in the Medical Record 100%
PQRS_EP_131_1 Pain Assessment and Follow-Up 83%
PQRS_EP_226_1 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 90%
PQRS_EP_47_1 Advance Care Plan 16%

Office Location

Street Address 99 MONTECILLO RD
City SAN RAFAEL
State CA
Zip Code 94903

Providers in the same location

NPI Name Taxonomy Address Enumeration
1346712114 Roger E Naval Respiratory Therapist, Registered 99 Montecillo Rd, San Rafael, CA 94903-3308 2018-12-18
1174095566 Sourav Kumar Respiratory Therapist, Registered 99 Montecillo Rd, San Rafael, CA 94903-3308 2018-12-22
1861964512 Melodee Ann Gutierrez Respiratory Therapist, Certified 99 Montecillo Rd, San Rafael, CA 94903-3308 2018-12-19
1275005936 Michael Anthony Larocco Respiratory Therapist, Registered 99 Montecillo Rd, San Rafael, CA 94903-3308 2018-12-19
1972075745 Joseph Tato Respiratory Therapist, Registered 99 Montecillo Rd, San Rafael, CA 94903-3308 2018-12-18
1952873721 Marie Kundysek Respiratory Therapist, Registered 99 Montecillo Rd, San Rafael, CA 94903-3308 2018-12-18
1689146458 Daphney Powell Respiratory Therapist, Registered 99 Montecillo Rd, San Rafael, CA 94903-3308 2018-12-18
1174094965 Jawana J Swanson Respiratory Therapist, Certified 99 Montecillo Rd, San Rafael, CA 94903-3308 2018-12-06
1033680897 David Yu Pharmacist 99 Montecillo Rd, San Rafael, CA 94903-3308 2018-12-05
1174011480 James Dillon Griffith Dietitian, Registered 99 Montecillo Rd, San Rafael, CA 94903-3308 2018-04-23
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679064836 California In Home Care & Registry, Inc In Home Supportive Care 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 2018-05-23
1467975755 Ashley Samantha Alvarez Counselor 1 St Vincent Drive, San Rafael, CA 94903 2017-07-19
1780122093 Janet Elizabeth Lane Counselor 4340 Redwood Highway, Building C, Suite 400, San Rafael, CA 94903 2017-02-07
1922557586 Helen Elizabeth Shamis Marriage & Family Therapist 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 2016-09-23
1033572771 Henry Colbert Counselor 1 St. St. Vincent Drive, San Rafael, CA 94903 2016-03-31
1659736924 Robyn Bloom Marriage & Family Therapist 4 Joseph Court, San Rafael, CA 94903 2015-12-30
1851760565 Cheryl Clementson Substance Abuse Rehabilitation Facility 301 Smith Ranch Road, San Rafael, CA 94903 2015-09-23
1588043731 Chelsea Choi Counselor 1 St. Vincent's Drive, San Rafael, CA 94903 2015-05-20
1235526138 David Tarantino Behavior Analyst 212 Paul Drive, Suite B, San Rafael, CA 94903 2015-04-20
1083002315 Kaiser Permanente Psychiatric Unit 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 2015-01-09
Find all providers in zip 94903

Taxonomy Information

Taxonomy Code 208600000X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery

Taxonomy Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1841379070 Frederick William Penczak Surgery 78 Creekside Dr, San Rafael, CA 94903-1055 2006-11-06
1245418086 Richard Elmer Geist Surgery 99 Montecillo Rd, San Rafael, CA 94903-3308 2008-02-04
1871677856 Edward W. Banks Surgery 99 Montecillo Rd, San Rafael, CA 94903-3308 2006-10-25
1619051687 Michael Parnes Surgery 99 Montecillo Rd, San Rafael, CA 94903-3308 2006-10-25
1306920376 Joe M. Zimmerman Surgery 99 Montecillo Rd, San Rafael, CA 94903-3308 2006-10-25
1851475826 Kenneth E. Novich Surgery 99 Montecillo Rd, San Rafael, CA 94903-3308 2006-10-25
1134203128 Mary B. Mockus Surgery 99 Montecillo Rd, San Rafael, CA 94903-3308 2006-10-25

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1154891208 Jay Labourene Surgery 1550 Tiburon Blvd Ste G, Tiburon, CA 94920-2531 2018-12-03
1215407218 Vascular and Endovascular Surgery, PC Surgery 2505 Samaritan Dr Ste 503, San Jose, CA 95124-4015 2018-12-03
1457829319 Cerritos Surgery Center, LLC Surgery 16543 Carmenita Rd, Cerritos, CA 90703-2218 2018-11-08
1902374010 Minimally Invasive Medical Group Surgery 26921 Crown Valley Pkwy Ste 120, Mission Viejo, CA 92691-6501 2018-11-06
1306328265 Wave Medical Group Inc Surgery 720 Paularino Ave Ste 200, Costa Mesa, CA 92626-6917 2018-09-06
1427539287 Mohammad Haghdoost Md Medical Cororation Surgery 1144 Norman Dr Ste 240, Manteca, CA 95336-5925 2018-08-28
1881170108 Newport Coast Surgical Center, LLC Surgery 4501 Birch St Ste A, Newport Beach, CA 92660-1928 2018-07-19
1982190716 Gracia Margaret Goade Surgery 16891 Calle De Sarah, Pacific Palisades, CA 90272-1952 2018-07-04
1073009171 Grace S Hwang Md Inc Surgery 1010 W La Veta Ave Ste 470, Orange, CA 92868 2018-07-02
1417448168 Inland Valley Trauma and Acute Care Surgery Apc Inc Surgery 36320 Inland Valley Dr Ste 101a, Wildomar, CA 92595 2018-05-29
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Competitor

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City SAN RAFAEL
Zip Code 94903

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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