Individual provider Active NPI

Ninna Nana

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1114511797
Registry record updated Sep 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C08151 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-1358
Fax
(410) 328-1897
NPI assigned
Feb 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C08151 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

804 Landmark Dr Ste 118
Glen Burnie, MD 21061-4486
Phone (410) 863-4899

Other practice location 1

116 Defense Hwy Ste 100
Annapolis, MD 21401-7040
Phone (410) 571-5545

Other practice location 2

5890 Waterloo Rd
Columbia, MD 21045-2617
Phone (667) 214-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20211108001036 MD Practitioner - Physician Assistant 1254720568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifebridge Community Gastroenterology LLCGroup PAC ID 7618108119, 54 clinicians

Practice addresses (Care Compare)

1838 Greene Tree Rd
Suite 180
Pikesville, MD 21208-7100
Phone (410) 602-7782

802 Landmark Dr
Suite 129
Glen Burnie, MD 21061-9121
Phone (410) 863-4899

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C08151MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pikesville MD Endoscopy ASC LLC Current Accepting new patients
Dr Wendy Kloesz, M.D., P.a Past Accepting new patients

Locations

1838 Greene Tree Rd
Ste 180
Pikesville, MD 21208
Phone (410) 358-1800

Interoperability endpoints

  • Direct secure messaging: nnana1309628@direct.hopkinsmedicine.org
  • Direct secure messaging: nnana849448@direct.umm.edu

Organizations & group practices 3

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 1

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": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789862400000",
    "number": "1114511797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 LANDMARK DR STE 118",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614486",
            "telephone_number": "410-863-4899",
            "fax_number": "443-873-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-1358",
            "fax_number": "410-328-1897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 Defense Hwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MD",
            "postal_code": "214017040",
            "country_code": "US",
            "telephone_number": "410-571-5545",
            "fax_number": "410-571-5334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5890 Waterloo Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210452617",
            "country_code": "US",
            "telephone_number": "667-214-2100",
            "fax_number": "410-799-9097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NANA",
        "first_name": "NINNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-24",
        "last_updated": "2026-09-20",
        "certification_date": "2026-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C08151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.