Individual provider Active NPI

Ann Marie Klecan, M.D.

  • Family Medicine Physician
  • Charlottesville, VA
National Provider Identifier
1871570002
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101054576 Issued in VA
Practice address
315 10TH St NE
Charlottesville, VA 22902
Phone
(434) 654-1950
Fax
(434) 977-9808
NPI assigned
Dec 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101054576 VA Primary

Addresses

Primary practice location

315 10TH St NE
Charlottesville, VA 22902

Mailing address

PO Box 79777
Baltimore, MD 21279-0777
Phone (434) 654-7794

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040309001146 VA Practitioner - Family Practice 3577451624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Stony Brook, School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Martha Jefferson Medical Group LLCGroup PAC ID 5991889081, 197 clinicians

Practice addresses (Care Compare)

1646 Park Ridge Dr
Crozet, VA 22932-3155
Phone (434) 654-2760

29 Jefferson CT
Zion Crossroads, VA 22942-9602
Phone (434) 654-8900

Hospital & facility affiliations

  • Sentara Home Care Services Home health agency, Charlottesville, VA, CCN 497019
  • Sentara Martha Jefferson Hospital Hospital, Charlottesville, VA, CCN 490077
  • University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009
  • Sentara RMH Medical Center Hospital, Harrisonburg, VA, CCN 490004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101054576VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Jefferson Medical Group LLC Family Medicine CurrentSince Dec 1, 2015 Accepting new patients
Charlottesville Pathology Associates PLC Current Accepting new patients
Martha Jefferson Hospital Past Accepting new patients

Locations

315 10th St NE
Charlottesville, VA 22902
Phone (434) 654-1950

920 E High St
Ste 201
Charlottesville, VA 22902
Phone (434) 654-1950

1646 Park Ridge Dr
Crozet, VA 22932
Phone (434) 654-2760

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 4

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1871570002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79777",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212790777",
            "telephone_number": "434-654-7794",
            "fax_number": "434-977-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 10TH ST NE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22902",
            "telephone_number": "434-654-1950",
            "fax_number": "434-977-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLECAN",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101054576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.