LOUDOUN MEDICAL GROUP PC (NPI# 1689798175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689798175 |
| Entity Type | Organization |
| Organization Name | LOUDOUN MEDICAL GROUP PC |
| Other Organization Name | LOUDOUN SURGICAL |
| Practice Address |
44055 Riverside Pkwy Suite 102 Leesburg VA 20176-5179 |
| Mailing Address |
Po Box 17334 Baltimore MD 21297-1334 |
| Practice Telephone | 7038583131 |
| Practice Fax Number | 7038583130 |
| Mailing Telephone | 7034436717 |
| Mailing Fax Number | 7034438643 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2012-10-02 |
| Authorized Official Name | MARY BETH TAMASY (CEO) |
| Authorized Official Telephone | 7037376010 |
| Is Organization Subpart | Y |
| Parent Organization Name | LOUDOUN MEDICAL GROUP PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | RR MEDICARE PIN | CG8678 | 01 |
| Other Name | Type Code |
|---|---|
| Loudoun Surgical | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891217857 | Loudoun Medical Group PC | Obstetrics & Gynecology | 3301 Woodburn Rd Ste 309, Annandale, VA 22003-7308 | 2017-07-12 |
| 1487107587 | Loudoun Medical Group PC | Specialist | 6355 Walker Ln Ste 303, Suite 303, Alexandria, VA 22310-3247 | 2016-07-26 |
| 1184077976 | Loudoun Medical Group PC | Ophthalmology | 1901 N Beauregard St, Suite 100, Alexandria, VA 22311-1738 | 2016-07-18 |
| 1659728889 | Loudoun Medical Group PC | Urology | 24430 Stone Springs Blvd, Suite 100, Dulles, VA 20166-2247 | 2016-05-18 |
| 1285093070 | Loudoun Medical Group PC | Obstetrics & Gynecology | 8292 Old Courthouse Rd, Suite C, Vienna, VA 22182-3834 | 2016-02-22 |
| 1841658499 | Loudoun Medical Group PC | Internal Medicine | 10200 Colvin Run Rd, Suite 326, Great Falls, VA 22066-1830 | 2016-02-10 |
| 1114303922 | Loudoun Medical Group PC | Surgery | 19415 Deerfield Ave Ste 213, Lansdowne, VA 20176-8471 | 2015-08-04 |
| 1285021345 | Loudoun Medical Group PC | Ophthalmology | 8751 Sudley Rd, 2nd Floor, Manassas, VA 20110-8319 | 2015-04-16 |
| 1821409590 | Loudoun Medical Group PC | Internal Medicine | 3687 Fettler Park Dr, Dumfries, VA 22025-2049 | 2014-05-15 |
| 1134530900 | Loudoun Medical Group PC | Internal Medicine | 4897 Prince William Pkwy, Suite C 102, Woodbridge, VA 22192-5432 | 2014-05-15 |
| Street Address |
44055 RIVERSIDE PKWY SUITE 102 |
| City | LEESBURG |
| State | VA |
| Zip Code | 20176-5179 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437141173 | Chauncey C Stokes IIi | Obstetrics & Gynecology | 44055 Riverside Pkwy, Suite 220, Leesburg, VA 20176-5179 | 2005-08-18 |
| 1033769906 | Sun Mi Cho | Nurse Practitioner | 44055 Riverside Pkwy, Suite 226, Leesburg, VA 20176 | 2019-09-12 |
| 1184174336 | Loudoun Medical Group . P.c | Internal Medicine | 44055 Riverside Pkwy, Suite 224, Leesburg, VA 20176-5179 | 2016-10-12 |
| 1437525201 | Eastern Cranial Affiliates, LLC | Prosthetic/Orthotic Supplier | 44055 Riverside Pkwy, Suite 106a, Leesburg, VA 20176-5179 | 2015-08-17 |
| 1306277793 | Loudoun Medical Group PC | Internal Medicine | 44055 Riverside Pkwy, Suite 224, Leesburg, VA 20176-5179 | 2013-12-10 |
| 1164778932 | Loudoun Medical Group PC | Internal Medicine | 44055 Riverside Pkwy, Suite 226, Leesburg, VA 20176-5179 | 2012-07-31 |
| 1881974939 | Valerie Sherman Oare | Nurse Practitioner | 44055 Riverside Pkwy, Suite 110, Leesburg, VA 20176-5179 | 2011-08-21 |
| 1801182878 | Janee Mao Leong | Obstetrics & Gynecology | 44055 Riverside Pkwy, Leesburg, VA 20176 | 2011-06-28 |
| 1144558768 | Nehal Jain | Physical Therapist | 44055 Riverside Pkwy, 118, Leesburg, VA 20176-5179 | 2009-11-19 |
| 1740419613 | The Critical Care Company Plc | Specialist | 44055 Riverside Pkwy, Leesburg, VA 20176-5179 | 2009-07-13 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396093043 | Gerard F. Melanson M.d., LLC | Surgery | 1016 North Blvd, East, Leesburg, FL 34748-5348 | 2012-08-28 |
| 1487788956 | Reagan Wei Quan | Surgery | 44055 Riverside Pkwy Ste 226, Leesburg, VA 20176-5177 | 2007-03-15 |
| 1558412486 | Samuel Bundz Md Pa | Surgery | 8112 Centralia Ct, Suite 101, Leesburg, FL 34788 | 2007-01-16 |
| 1174604094 | Yohannes Mahtemework | Surgery | 528 Legrace Ter Ne, Leesburg, VA 20176-1828 | 2006-10-18 |
| 1558745794 | Loudoun Medical Group PC | Surgery | 19415 Deerfield Ave, Suite 213, Leesburg, VA 20176-8452 | 2015-07-17 |
| 1275970618 | Physician Surgical Assists, LLC | Surgery | 224-d Cornwall Street, Nw, Suite 300, Leesburg, VA 20176 | 2013-05-24 |
| 1134416290 | John Johnson Mcelveen Jr. | Surgery | 19441 Golf Vista Plz Ste 230&310, Leesburg, VA 20176-8269 | 2011-07-08 |
| 1104063114 | Leesburg Regional Medical Center Physician Services LLC | Surgery | 600 E Dixie Ave, Leesburg, FL 34748-5925 | 2009-01-13 |
| 1659538478 | Virginia P Madey | Surgery | 44055 Riverside Pkwy, Suite 246, Leesburg, VA 20176-5179 | 2008-05-20 |
| 1457548844 | Samuel Bundz | Surgery | 8112 Centralia Ct, Suite 101, Leesburg, FL 34788 | 2007-09-28 |
| Find all providers in LEESBURG | ||||
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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.