NPIMap

Individual provider Active NPI

Hannah Angelella

  • Physician Assistant
  • Altavista, VA
National Provider Identifier
1942995402
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110010585 Issued in VA
Practice address
1280A Main St
Altavista, VA 24517-1465
Phone
(434) 309-1165
NPI assigned
Apr 10, 2023
Last updated
Dec 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0009091 MD
Physician Assistant 363A00000X
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 0110010585 VA Primary

Addresses

Primary practice location

1280A Main St
Altavista, VA 24517-1465

Mailing address

1280A Main St
Altavista, VA 24517-1465

Other practice location 1

542 Rich Mar St
Westminster, MD 21158-9467
Phone (443) 929-0253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, VA2 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
I20231129000898 MD Practitioner - Physician Assistant 7315395522 Reassigns benefits to 1 organization
I20250314001799 VA Practitioner - Physician Assistant 7315395522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

1280 Main St a
Altavista, VA 24517-1465
Phone (434) 309-1165

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 947-3033

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0009091MDMDPhysician Assistant
0110010585VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Dec 1, 2023 Accepting new patients
Centra Medical Group, LLC Single Specialty CurrentSince Feb 1, 2025 Accepting new patients
Cep America LLC Single Specialty CurrentSince Dec 1, 2023 Accepting new patients
Centra Medical Group, LLC Single Specialty CurrentSince Feb 1, 2025 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

1280A Main St
Altavista, VA 24517
Phone (434) 309-1165

140 Vista Centre Dr
Fl 2
Forest, VA 24551
Phone (434) 200-2297

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1942995402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280A MAIN ST",
            "city": "ALTAVISTA",
            "state": "VA",
            "postal_code": "245171465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280A MAIN ST",
            "city": "ALTAVISTA",
            "state": "VA",
            "postal_code": "245171465",
            "telephone_number": "434-309-1165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "542 Rich Mar St",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "MD",
            "postal_code": "211589467",
            "country_code": "US",
            "telephone_number": "443-929-0253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANGELELLA",
        "first_name": "HANNAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0009091",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altavista, VA

Sources for this page

Verify at the official NPI Registry.