LOUDOUN MEDICAL GROUP PC (NPI# 1134413230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134413230 |
| Entity Type | Organization |
| Organization Name | LOUDOUN MEDICAL GROUP PC |
| Other Organization Name | ORTHOPAEDIC & SPINE SURGERY INSTITUTE |
| Practice Address |
19450 Deerfield Ave Ste 300 Leesburg VA 20176-6821 |
| Mailing Address |
Po Box 17334 Baltimore MD 21297-1334 |
| Practice Telephone | 7037236774 |
| Practice Fax Number | 7037231494 |
| Mailing Telephone | 7034436717 |
| Mailing Fax Number | 7034438643 |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2018-12-28 |
| 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 | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Orthopaedic & Spine Surgery Institute | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 19465 Deerfield Ave, Suite 207, Leesburg, VA 201761701 | 7037236774 | 7037231494 |
| 19450 Deerfield Ave Ste 300, Leesburg, VA 201766821 | 7037236774 | 7037231494 |
| 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 |
19450 DEERFIELD AVE STE 300 |
| City | LEESBURG |
| State | VA |
| Zip Code | 20176-6821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629077854 | Ian Michael Wattenmaker | Orthopaedic Surgery | 19450 Deerfield Ave Ste 300, Leesburg, VA 20176-6821 | 2005-07-19 |
| 1982148441 | Loudoun Medical Group, P.C. | Specialist | 19450 Deerfield Ave Ste 300, Leesburg, VA 20176-6821 | 2016-12-16 |
| 1225130966 | Ali Moshirfar | Orthopaedic Surgery | 19450 Deerfield Ave Ste 300, Leesburg, VA 20176-6821 | 2006-09-02 |
| 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 | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588941629 | Csssdwc | Orthopaedic Surgery | 224d Cornwall St Nw, Suite 204, Leesburg, VA 20176-2700 | 2011-11-03 |
| 1134427453 | Orthopaedic & Spine Surgery Institute Pllc | Orthopaedic Surgery | 19465 Deerfield Ave, Suite 207 & 307, Leesburg, VA 20176-1701 | 2011-03-10 |
| 1164698999 | Loudoun Medical Group PC | Orthopaedic Surgery | 224 D Cornwall Street Nw, Suite 204, Leesburg, VA 20176 | 2008-05-01 |
| 1225130966 | Ali Moshirfar | Orthopaedic Surgery | 19450 Deerfield Ave Ste 300, Leesburg, VA 20176-6821 | 2006-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548883192 | Spine Center PC | Orthopaedic Surgery | 2726 Electric Rd Ste 203a, Roanoke, VA 24018-3528 | 2020-05-18 |
| 1992299598 | Hasz Spine Institute PC | Orthopaedic Surgery | 1830 Town Center Dr Ste 102, Reston, VA 20190-3216 | 2018-06-18 |
| 1881188506 | Nikhil Jain | Orthopaedic Surgery | 1215 Lee St - Box Number 800159, Charlottesville, VA 22908-0816 | 2018-06-16 |
| 1922516806 | Joint Replacement Cin of Northern Virginia LLC | Orthopaedic Surgery | 1900 Campus Commons Dr Ste 100a, Reston, VA 20191-1561 | 2018-01-13 |
| 1134562051 | Elliott Jiwoo Kim | Orthopaedic Surgery | 1635 N George Mason Dr Ste 310, Arlington, VA 22205-3616 | 2013-04-10 |
| 1255695490 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 2046 Jefferson Davis Hwy, 103, Stafford, VA 22554-7276 | 2012-07-03 |
| 1134490311 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 1625 N George Mason Drive Suite 345, Arlington, VA 22205 | 2012-01-20 |
| 1831426204 | Maryview Hospital | Orthopaedic Surgery | 5838 Harbour View Blvd Ste 100, Suffolk, VA 23435-2663 | 2009-11-05 |
| 1144403262 | Kirven Orthopedic Group, P.C. | Orthopaedic Surgery | 5701 Cleveland Street, Suite 600, Virginia Beach, VA 23462 | 2007-12-12 |
| 1699859058 | Adel S Kebaish | Orthopaedic Surgery | 7787 Leesburg Pike, B, Falls Church, VA 22043-2412 | 2006-10-24 |
| Find all providers with the same taxonomy | ||||
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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.