NPIMap

Individual provider Active NPI

Angeline Johny

  • Urology Physician
  • Philadelphia, PA
National Provider Identifier
1578025417
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD484693 Issued in PA
Practice address
3400 Civic Center Blvd
West Pavilion, 3Rd Floor
Philadelphia, PA 19104-5127
Phone
(301) 503-4765
NPI assigned
Apr 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD484693 PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd
West Pavilion, 3Rd Floor
Philadelphia, PA 19104-5127

Mailing address

3400 Civic Center Blvd
3Rd Floor, West Pavilion
Philadelphia, PA 19104
Phone (301) 503-4765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DC2 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
I20240607000049 PA Practitioner - Urology 0648712570 Reassigns benefits to 1 organization
I20250412000354 DC Practitioner - Urology 0648712570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suburban/NRH Medical Rehabilitation IncGroup PAC ID 6507846771, 885 clinicians
Chesapeake Urology Associates LLCGroup PAC ID 4789673393, 161 clinicians

Practice addresses (Care Compare)

6410 Rockledge Dr
Bethesda, MD 20817-1844

6410 Rockledge Dr
Suite 503
Bethesda, MD 20817-7822
Phone (301) 530-1700

Hospital & facility affiliations

  • Suburban Hospital Hospital, Bethesda, MD, CCN 210022
  • Holy Cross Germantown Hospital Hospital, Germantown, MD, CCN 210065
  • University of MD Baltimore Washington Medical Center Hospital, Glen Burnie, MD, CCN 210043
  • Sibley Memorial Hospital Hospital, Washington, DC, CCN 090005
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD484693PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Urology Associates LLC Urology CurrentSince Apr 1, 2025 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2024 Accepting new patients
University of Penn-Medical Group Urology CurrentSince Jul 1, 2024 Accepting new patients
Chesapeake Urology Associates, LLC Urology Current Accepting new patients
Chesapeake Urology Associates, LLC CurrentSince Apr 1, 2025 Accepting new patients
University of Penn-Medical Group Current Accepting new patients

Locations

6410 Rockledge Dr
Ste 503
Bethesda, MD 20817
Phone (301) 530-1700

10200 Grand Central Ave
Ste 220
Owings Mills, MD 21117

3801 International Dr
Ste 310
Silver Spring, MD 20906
Phone (301) 598-9171

3400 Convention Ave
Philadelphia, PA 19104
Phone (215) 662-2300

3400 Civic Center Blvd
Fl 3
Philadelphia, PA 19104
Phone (215) 614-4100

Interoperability endpoints

  • Direct secure messaging: angelinejohny@tsicua.allscriptsdirect.net
  • Direct secure messaging: ajohny4668089@direct.trinity-health.org
  • Direct secure messaging: ajohny83153@direct.umm.edu
  • Direct secure messaging: ajohny1379402@direct.hopkinsmedicine.org

Organizations & group practices 7

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 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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1578025417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "3RD FLOOR, WEST PAVILION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "301-503-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "WEST PAVILION, 3RD FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "301-503-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNY",
        "first_name": "ANGELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD484693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.