LOUDOUN MEDICAL GROUP PC (NPI# 1760879902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760879902 |
| Entity Type | Organization |
| Organization Name | LOUDOUN MEDICAL GROUP PC |
| Other Organization Name | THE EYE CENTER |
| Practice Address |
21475 Ridgetop Cir Suite 300 Sterling VA 20166-6580 |
| Mailing Address |
Po Box 17334 Baltimore MD 21297-1334 |
| Practice Telephone | 7034304400 |
| Practice Fax Number | 7034304130 |
| Mailing Telephone | 7034436717 |
| Mailing Fax Number | 7034438643 |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2015-05-29 |
| 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 | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| The Eye Center | 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 |
21475 RIDGETOP CIR SUITE 300 |
| City | STERLING |
| State | VA |
| Zip Code | 20166-6580 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407837727 | Ivey G Peterson | Physician Assistant | 21475 Ridgetop Cir, Suite 150, Sterling, VA 20166-6580 | 2005-11-14 |
| 1255880852 | Roshan Patel | Physical Therapist | 21475 Ridgetop Cir, Sterling, VA 20166-6580 | 2016-09-25 |
| 1023499522 | Casey Lynn Baumgardner | Physician Assistant | 21475 Ridgetop Cir, Ste150, Sterling, VA 20166-6580 | 2015-06-11 |
| 1982019105 | Cory Edward Kraftson | Physician Assistant | 21475 Ridgetop Cir, Suite 150, Sterling, VA 20166-6580 | 2014-06-26 |
| 1780096479 | Tatiana Staver | Dentist | 21475 Ridgetop Cir, Suite 200, Sterling, VA 20166-6580 | 2014-05-29 |
| 1871936765 | Erin Holland | Occupational Therapist | 21475 Ridgetop Cir, Suite 260, Sterling, VA 20166-6580 | 2013-04-10 |
| 1548523533 | David Saul Levine | Orthopaedic Surgery | 21475 Ridgetop Cir, Ste 150, Sterling, VA 20166-8521 | 2012-06-25 |
| 1457612301 | Deanna Busteed | Dietitian, Registered | 21475 Ridgetop Cir, Suite 150, Sterling, VA 20166-6580 | 2012-06-06 |
| 1225303704 | Diana Vartui Sensenbrenner | Dentist | 21475 Ridgetop Cir, Suite Number 230, Sterling, VA 20166-6580 | 2012-03-15 |
| 1285906388 | Alexis L. Williams | Physician Assistant | 21475 Ridgetop Cir, Suite 150, Sterling, VA 20166-6580 | 2012-02-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881187458 | Vincent Seng | Behavior Technician | 4040 Center Oak Plaza, Suite 150, Sterling, VA 20166 | 2018-06-08 |
| 1205339348 | Morgan Elyse Gillum | Occupational Therapist | 45305 Catalina Ct Ste 101, Sterling, VA 20166 | 2018-03-15 |
| 1376090548 | Chelsea Moore | Behavioral Analyst | 46040 Center Oak Plz Ste 150, Sterling, VA 20166 | 2016-09-06 |
| 1194175711 | Krisha Verma | Dentist | 21631 Ridgetop Cir Ste 240, Sterling, VA 20166 | 2016-06-14 |
| 1265898571 | Bba Home Health Care | Home Health | 23420 Summerstown Place, Dulles, VA 20166 | 2016-01-04 |
| 1588038590 | Mancy Modi | Physical Therapist | 45305 Catalina Court, Suite 103, Sterling, VA 20166 | 2015-11-16 |
| 1912300377 | Kiley Coleman Gibbs | Physical Therapist | 21631 Ridgetop Cir Ste 225a, Sterling, VA 20166 | 2014-09-30 |
| 1053712554 | Rx Ante Pharmacy Services, LLC | Pharmacy | 21630 Ridgetop Circle, Suite 100, Sterling, VA 20166 | 2014-09-16 |
| 1972904738 | Northern Virginia Community Hospital LLC | General Acute Care Hospital | 24440 Stone Springs Boulevard, Dulles, VA 20166 | 2014-09-11 |
| 1518304641 | Institute for The Psychological Sciences | Psychologist | 45154 Underwood Ln., Sterling, VA 20166 | 2013-05-30 |
| Find all providers in zip 20166 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| 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 Ophthalmology, 2007. http://www.abop.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 Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912095019 | Darrell Steven Reisner | Ophthalmology | 21475 Ridgetop Cir Ste 300, Sterling, VA 20166-8580 | 2006-10-11 |
| 1982678223 | William F Deegan IIi | Ophthalmology | 46161 Westlake Dr Ste 300, Sterling, VA 20165-5871 | 2006-02-14 |
| 1447223888 | Mohammed Kairy Barazi | Ophthalmology | 21351 Ridgetop Cir, Suite 140, Sterling, VA 20166-6561 | 2006-02-08 |
| 1548260961 | John M Hahn | Ophthalmology | 10 W 3rd St, Sterling, IL 61081-3503 | 2005-07-28 |
| 1215268131 | Sterling Eye Care & Surgery, P.C. | Ophthalmology | 1414 S 3rd Ave, Sterling, CO 80751-4650 | 2010-01-15 |
| 1366688160 | Arlington Loudoun Pediatric Ophthalmology Pllc | Ophthalmology | 46161 Westlake Dr, Suite 300, Sterling, VA 20165-5871 | 2008-12-29 |
| 1821137738 | Joanne Crenshaw, Md PC | Ophthalmology | 21135 Whitfield Place, Suite 102, Sterling, VA 20165-7279 | 2007-02-06 |
| 1144397258 | Tamer Mansour | Ophthalmology | 21475 Ridgetop Cir Ste 300, Sterling, VA 20166-8580 | 2006-11-30 |
| 1710069950 | Northern Virginia Vision Center, Inc. | Ophthalmology | 21475 Ridgetop Circle, Suite 300, Sterling, VA 20166-6580 | 2006-10-19 |
| 1366523102 | Christina L. Butera | Ophthalmology | 21475 Ridgetop Cir, Suite 300, Sterling, VA 20166-6580 | 2006-10-18 |
| Find all providers in STERLING | ||||
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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.