Individual provider Active NPI

Tamara Susan Smith, M.D.

  • Allergy & Immunology Physician
  • Gainesville, VA
National Provider Identifier
1225127129
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
0101243112 Issued in VA
Practice address
14535 John Marshall Hwy, Suite 212
Gainesville, VA 20155-4025
Phone
(571) 248-0245
Fax
(571) 248-0241
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101243112 VA
Internal Medicine Physician 207R00000X 21653 WV
Allergy & Immunology Physician 207K00000X 0101243112 VA Primary

Addresses

Primary practice location

14535 John Marshall Hwy, Suite 212
Gainesville, VA 20155-4025

Mailing address

224 D Cornwall Street NW
Ste 403
Leesburg, VA 20176-2704
Phone (703) 737-6010

Other identifiers 2

IdentifierTypeStateIssuer
30016040950001MedicaidVA
1225127129MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130125000073 VA Practitioner - Allergy/Immunology 8729232848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loudoun Medical Group, PCGroup PAC ID 0042119661, 272 clinicians

Practice addresses (Care Compare)

20955 Professional PLZ
Suite 200
Ashburn, VA 20147-3405
Phone (703) 729-7652

Merit-based Incentive Payment System (MIPS)

Final score
92.65 of 100Reported as apm
Quality
85.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21653WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Group, PC Internal Medicine CurrentSince Mar 1, 2013 Accepting new patients

Locations

6355 Walker Ln
Ste 308
Alexandria, VA 22310
Phone (703) 313-7700

20955 Professional Plz
Ste 200
Ashburn, VA 20147
Phone (703) 729-7652

14535 John Marshall Hwy
Ste 212
Gainesville, VA 20155
Phone (571) 248-0245

224D Cornwall St NW
Ste 403
Leesburg, VA 20176
Phone (703) 737-6001

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1225127129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 D CORNWALL STREET NW",
            "address_2": "STE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14535 JOHN MARSHALL HWY, SUITE 212",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201554025",
            "telephone_number": "571-248-0245",
            "fax_number": "571-248-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TAMARA",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101243112",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "21653",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "VA",
            "license": "0101243112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30016040950001",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225127129",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, VA

Sources for this page

Verify at the official NPI Registry.