LOUDOUN MEDICAL GROUP PC (NPI# 1831375294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831375294 |
| Entity Type | Organization |
| Organization Name | LOUDOUN MEDICAL GROUP PC |
| Other Organization Name | NORTHERN VIRGINIA ENT ASSOCIATES |
| Practice Address |
224 D Cornwall Street Nw Suite 306 Leesburg VA 20176 |
| Mailing Address |
Po Box 17334 Baltimore MD 21297-1334 |
| Practice Telephone | 7037298080 |
| Mailing Telephone | 7034436717 |
| Mailing Fax Number | 7034438643 |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2014-04-30 |
| 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 | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | RR MEDICARE GROUP PIN | CG8678 | 01 |
| Other Name | Type Code |
|---|---|
| Northern Virginia ENT Associates | 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 |
224 D CORNWALL STREET NW SUITE 306 |
| City | LEESBURG |
| State | VA |
| Zip Code | 20176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346342565 | James Ticknor Gable | Orthopaedic Surgery | 224 D Cornwall Street Nw, Suite 204, Leesburg, VA 20176-4407 | 2006-09-01 |
| 1164698999 | Loudoun Medical Group PC | Orthopaedic Surgery | 224 D Cornwall Street Nw, Suite 204, Leesburg, VA 20176 | 2008-05-01 |
| 1619143443 | Loudoun Medical Group PC | Physical Medicine & Rehabilitation | 224 D Cornwall Street Nw, Suite 202, Leesburg, VA 20176 | 2008-05-01 |
| 1679759039 | Loudoun Medical Group PC | Urology | 224 D Cornwall Street Nw, Suite 400, Leesburg, VA 20176 | 2008-01-16 |
| 1912183294 | Loudoun Medical Group PC | Orthopaedic Surgery | 224 D Cornwall Street Nw, Suite 204, Leesburg, VA 20176 | 2008-01-16 |
| 1083890404 | Loudoun Medical Group PC | Pediatrics | 224 D Cornwall Street Nw, Suite 104, Leesburg, VA 20176 | 2008-01-16 |
| 1528244951 | Loudoun Medical Group PC | Family Medicine | 224 D Cornwall Street Nw, Suite106, Leesburg, VA 20176 | 2008-01-16 |
| 1194901512 | Loudoun Medical Group PC | Internal Medicine | 224 D Cornwall Street Nw, Suite 102, Leesburg, VA 20176 | 2008-01-16 |
| 1740466028 | Loudoun Medical Group PC | Orthopaedic Surgery | 224 D Cornwall Street Nw, Suite 204, Leesburg, VA 20176 | 2008-01-16 |
| 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 | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699753442 | Mahesh Sarma Parameswaran | Otolaryngology | 19490 Sandridge Way Ste 230, Leesburg, VA 20176-3467 | 2006-01-03 |
| 1780684399 | Dino Madonna | Otolaryngology | 601 E Dixie Ave, Medical Plaza 901, Leesburg, FL 34748-5953 | 2005-07-26 |
| 1912161977 | Roya Azadarmaki | Otolaryngology | 19450 Deerfield Ave, Suite 400, Leesburg, VA 20176-6820 | 2008-07-17 |
| 1043402241 | Loudoun Medical Group PC | Otolaryngology | 224d Cornwall St Nw, Suite 304, Leesburg, VA 20176-2700 | 2007-08-13 |
| 1215051693 | Loudoun Medical Group PC | Otolaryngology | 44035 Riverside Pkwy, Suite 450, Leesburg, VA 20176-8260 | 2007-03-19 |
| 1235253741 | Loudoun Medical Group PC | Otolaryngology | 19465 Deerfield Ave, Suite 301, Leesburg, VA 20176-1701 | 2007-03-19 |
| 1053491704 | Elisabeth Ann Fox | Otolaryngology | 19455 Deerfield Ave, Suite 301, Leesburg, VA 20176 | 2006-10-17 |
| 1568433548 | Euclid A Isbell Jr. | Otolaryngology | 601 E Dixie Ave, Leesburg, FL 34748-5953 | 2006-01-30 |
| 1124028618 | Judith Carol Milstead | Otolaryngology | 601 E Dixie Ave, Medical Plaza 901, Leesburg, FL 34748-5953 | 2005-07-26 |
| 1619977220 | Sammy Dwight Vaught | Otolaryngology | 601 E Dixie Ave, Medical Plaza 901, Leesburg, FL 34748-5953 | 2005-07-26 |
| 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.