NPIMap

Individual provider Active NPI

Angela L Jellison, MD

  • Vascular Surgery Physician
  • Rochester, NH
National Provider Identifier
1356661250
Registry record updated Aug 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
18180 Issued in NH
Practice address
11 Whitehall Rd
Rochester, NH 03867-3226
Phone
(603) 332-5211
NPI assigned
Jun 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 18180 NH Primary

Addresses

Primary practice location

11 Whitehall Rd
Rochester, NH 03867-3226

Mailing address

11 Whitehall Rd
Rochester, NH 03867-3226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20180213001110 MA Practitioner - Vascular SurgeryPractitioner - General Surgery 6002042769 Reassigns benefits to 4 organizations
I20260311001922 NH Practitioner - Vascular Surgery 6002042769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10
Removal of tissue149
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18180NHMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Lahey Clinic, Inc CurrentSince Feb 5, 2018 Accepting new patients
Lahey Clinic, Inc. CurrentSince Feb 5, 2018 Accepting new patients
Winchester Physician Associates, Inc CurrentSince Mar 8, 2024 Accepting new patients
Lahey Clinic, Inc. CurrentSince Jan 31, 2026 Accepting new patients
Winchester Physician Associates Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

75 Riverside Ave
Ste 2
Medford, MA 02155
Phone (781) 306-0200

75 Riverside Ave
Ste 4
Medford, MA 02155
Phone (781) 756-7095

203 Main St
North Reading, MA 01864
Phone (978) 664-1990

Interoperability endpoints

  • Direct secure messaging: ajellison99079@direct.bilh.masshiway.net

Organizations & group practices 6

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 5

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": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502236800000",
    "number": "1356661250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 WHITEHALL RD",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038673226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 WHITEHALL RD",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038673226",
            "telephone_number": "603-332-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELLISON",
        "first_name": "ANGELA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2017-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NH",
            "license": "18180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NH

Sources for this page

Verify at the official NPI Registry.