NPIMap

Individual provider Active NPI

Jella Angela An, M.D.

  • Ophthalmology Physician
  • Columbia, MO
National Provider Identifier
1033567763
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D92510 Issued in MD
Practice address
One Hospital Drive
Columbia, MO 65212-0001
Phone
(573) 882-1506
Fax
(573) 884-5575
NPI assigned
Jun 3, 2016
Last updated
Apr 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 2016008029 MO
Ophthalmology Physician 207W00000X D92510 MD Primary
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X 2016008029 MO

Addresses

Primary practice location

One Hospital Drive
Columbia, MO 65212-0001

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004

Other identifiers 1

IdentifierTypeStateIssuer
D92510OtherMDMD LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, SC3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210913003168 MD Practitioner - Ophthalmology 6204128242 Reassigns benefits to 1 organization
I20210913003207 DC Practitioner - Ophthalmology 6204128242 Reassigns benefits to 1 organization
I20240917002672 SC Practitioner - Ophthalmology 6204128242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
McGill University, Faculty of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery166

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D92510MDMDOphthalmology Physician
2016008029MOMDGlaucoma Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
Johns Hopkins University CurrentSince Sep 2, 2021 Accepting new patients
Johns Hopkins University Ophthalmology CurrentSince Sep 2, 2021 Accepting new patients
Johns Hopkins University Ophthalmology CurrentSince Sep 2, 2021 Accepting new patients
Johns Hopkins University Ophthalmology CurrentSince Sep 2, 2021 Accepting new patients
Johns Hopkins University Current Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Aug 28, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

8600 Old Georgetown Rd
Bethesda, MD 20814
Phone (301) 896-2578

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

10751 Falls Rd
Timonium, MD 21093
Phone (410) 583-2727

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Interoperability endpoints

  • Direct secure messaging: jan487250@direct.musc.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1033567763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE HOSPITAL DRIVE",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-882-1506",
            "fax_number": "573-884-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AN",
        "first_name": "JELLA",
        "middle_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "2016008029",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D92510",
            "primary": true
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "MO",
            "license": "2016008029",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "D92510",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.