Jacalyn Renee Ely, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TA0781 Issued in MD

Practice address

3933 Ferrara Dr
Silver Spring, MD 20906-4709

Phone

(301) 946-2550

Fax

(301) 946-2551

NPI assigned

Jul 18, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Maryland Professional LLCGroup PAC ID 7618316902, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aeg Maryland Professional LLC

  • Optometrist
  • Gaithersburg, MD
  • NPI 1962182782
  Medicare reassignment Care Compare group NPD
• DRS Ely and Cohen Optometry of Maple Lawn LLC

  dba Maple Lawn Eye Care Center

  • Optometrist
  • Fulton, MD
  • NPI 1750720991
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356369011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7534 BROADCLOTH WAY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462446",
            "telephone_number": "410-381-5412",
            "fax_number": "301-854-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3933 FERRARA DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209064709",
            "telephone_number": "301-946-2550",
            "fax_number": "301-946-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELY",
        "first_name": "JACALYN",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA0781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerard Elonge - Fobia, HHA
• Elsabet Tekle DDS LLC
• Elsabet Tekle DDS LLC
• Elsie Turner MD
• Lucia Duarte Elstrom, LCSWC
• Lisa Kirsten Ely, MD
• Stephanie N Emaha
• Rebecca Emambu
• Embrace Primary Care, LLC
• Chizoba Emejue

• Optometrist in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.