ANGELO JOHN ALFANO (FNP) – Family Nurse Practitioner, NPI 1023503307

ANGELO JOHN ALFANO (FNP) is a healthcare provider. based in Lakeport, California. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 915124825 (CA). The NPI Number for ANGELO JOHN ALFANO (FNP) is 1023503307

Main info

Male
8 Years Of Experience
Name
ANGELO JOHN ALFANO (FNP)
NPI
1023503307
Phone
(707) 263-8383
Address
925 Bevins Court
Enumeration Date
28 June 2018
Last Update Date
29 October 2024

Doctor Profile

Medical School Name
YALE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7079946486
Graduation Year
2018 (8 years ago)
PAC ID
9931446994
Group Practice PAC ID
3072421197
Professional Enrollment ID
I20190129001922
Address ID
CA954229336CL15630AVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:7State licenses:2Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for ANGELO JOHN ALFANO (FNP)

  • 925 Bevins Court

    Lakeport, CA 954539754

    Phone: (707) 263-8383

    Fax: (707) 263-5019

    Type: Location

  • 14440 Olympic Drive

    Clearlake, CA 954228809

    Phone: (707) 263-8383

    Fax: (707) 263-5019

    Type: Location

  • 9th Street, Arcata, Humboldt County, California, 95518-4448, United States

    ARCATA, CA 955216249

    Phone: (707) 826-8633

    Type: Mailing

  • 2200, Tydd Street, Eureka, Humboldt County, California, 95501, United States

    EUREKA, CA 955011284

    Phone: (707) 441-1624

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-01-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190129001922INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95453)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3072421197View full group profile
NameSpecialtyState
Diagnostic RadiologyCA
Clinical Social WorkerCA
Nurse PractitionerCA
Diagnostic RadiologyCA
Clinical Social WorkerCA
Diagnostic RadiologyCA
N E U R O L O G YCT
Clinical PsychologistWA
General SurgeryCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

How do I look up ANGELO JOHN ALFANO (FNP) by NPI?
Use NPI 1023503307 when you need to reference ANGELO JOHN ALFANO (FNP) in forms, claims, or directories.
Does this profile mean ANGELO JOHN ALFANO (FNP) is currently active?
Yes — ANGELO JOHN ALFANO (FNP) appears active in the national provider directory.
What does ANGELO JOHN ALFANO (FNP) treat or focus on?
Patients typically see ANGELO JOHN ALFANO (FNP) under the specialty Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does ANGELO JOHN ALFANO (FNP) practice in California?
You will see Lakeport, California on file for ANGELO JOHN ALFANO (FNP) alongside any extra practice locations.
How can I contact ANGELO JOHN ALFANO (FNP)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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