PREMIER TRAUMA AND SURGICAL SPECIALISTS LLC (NPI# 1447796073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447796073 |
| Entity Type | Organization |
| Organization Name | PREMIER TRAUMA AND SURGICAL SPECIALISTS LLC |
| Practice Address |
44045 Riverside Pkwy Leesburg VA 20176-5101 |
| Mailing Address |
Po Box 79295 Baltimore MD 21279-9295 |
| Practice Telephone | 7038586040 |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2017-04-19 |
| Authorized Official Name | EDWARD PUCCIO (PRESIDENT) |
| Authorized Official Telephone | 7038586044 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437781523 | Premier Trauma and Surgical Specialists LLC | Physician Assistant | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2020-02-07 |
| Street Address |
44045 RIVERSIDE PKWY |
| City | LEESBURG |
| State | VA |
| Zip Code | 20176-5101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023016821 | Jennifer Gut | Nurse Anesthetist, Certified Registered | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2005-07-14 |
| 1376161885 | Alexis Lydia Doherty | Nurse Practitioner | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2020-07-10 |
| 1942821038 | Melissa Lynn Hwang | Registered Nurse | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2020-04-30 |
| 1366061574 | Commonwealth Emergency Physicians PC | Nurse Practitioner | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2020-04-09 |
| 1497387328 | Hannah Burzumato | Nurse Anesthetist, Certified Registered | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2020-02-08 |
| 1437781523 | Premier Trauma and Surgical Specialists LLC | Physician Assistant | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2020-02-07 |
| 1023640182 | Margaret Smith Lynch | Nurse Practitioner | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2020-02-06 |
| 1427694454 | Mary Christine Hogan | Nurse Practitioner | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2019-11-25 |
| 1669020442 | Brittany Marie Colley | Radiology | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2019-08-26 |
| 1457837395 | Susan Park Howell | Nurse Practitioner | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2018-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912923 | Timothy Michael Nixon | Pharmacist | 61 Catoctin Circle, Leesburg, VA 20176 | 2020-11-05 |
| 1558996645 | Stacey E Moran | Occupational Therapist | 44124 Woodrige Parkway, Lansdowne, VA 20176 | 2020-03-09 |
| 1710531272 | Joseph H Kasuska Jr. | Specialist/Technologist | 19455 Deerfield Ave. Suite 306, Lansdowne, VA 20176 | 2019-08-01 |
| 1568935849 | Joel Manalang Polintan Jr. | Physical Therapist | 171 Cedarwalk Circle, Leesburg, VA 20176 | 2019-01-09 |
| 1194203026 | Jing Cao | Acupuncturist | 19450 Deerfield Ave Ste 275, Leesburg, VA 20176 | 2018-08-02 |
| 1134648314 | Alaina Marie Gotwalt | Speech-Language Pathologist | 43850 Heatherstone Terrace, Unit 406, Leesburg, VA 20176 | 2017-09-19 |
| 1841717105 | Happy Inhome Care Corp | Respite Care | 722 E Market St Ste 103, Leesburg, VA 20176 | 2017-08-28 |
| 1912423484 | Aaa Good Healthcare LLC | Nursing Care | 722 East Market Street Ne, Suite 102, Leesburg, VA 20176 | 2017-08-16 |
| 1740704253 | Anna Maria Domingo Seaford | Physician Assistant | 19441 Golf Vista Plz Ste 230, Lansdowne, VA 20176 | 2017-07-27 |
| 1710436480 | Reena Patel | Physician Assistant | 224 Cornwall St Nw Leesburg Orthope, Unit 204, Leesburg, VA 20176 | 2016-09-23 |
| Find all providers in zip 20176 | ||||
| Taxonomy Code | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528685120 | Hannah Beam | Surgery | 1627 Farmington Dr, Forest, VA 24551-5612 | 2020-06-30 |
| 1023582046 | Lauren Elizabeth Rusy | Surgery | 111 Lighthouse Ln, Winchester, VA 22602-6191 | 2019-01-12 |
| 1548467855 | Timothy Joshua Donahue | Surgery | 2110 Marina Shores Dr # 330, Virginia Beach, VA 23451-6800 | 2007-06-29 |
| 1164495040 | Thomas Preston Davis | Surgery | 1148 Kingsbury Dr, Chesapeake, VA 23322-4264 | 2006-02-10 |
| 1417466780 | Hamdy Medical Center PC | Surgery | 110 Commonwealth Blvd W, Martinsville, VA 24112-1913 | 2017-09-29 |
| 1952573370 | Tedla T Tessema | Surgery | 1101 Sam Perry Blvd, Suite 219, Fredericksburg, VA 22401-4467 | 2008-03-26 |
| 1902076169 | Paula E Ferrada | Surgery | 1250 E Marshall St, Surgery, Richmond, VA 23298-5051 | 2008-03-04 |
| 1427241090 | Medidoctors LLC | Surgery | 1101 Sam Perry Blvd, Suite 314, Fredericksburg, VA 22401-4467 | 2007-08-27 |
| 1144425034 | Rahul Jagdish Anand | Surgery | 1250 E Marshall St, Surgery, Richmond, VA 23298-5051 | 2007-06-19 |
| 1902993041 | Bryan Collier | Surgery | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2006-10-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.