Individual provider Active NPI

Jon William Mader, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Leesburg, VA
National Provider Identifier
1255656864
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0101259167 Issued in VA
Practice address
44055 Riverside Parkway, Suite 216
Leesburg, VA 20176
Phone
(703) 840-0665
Fax
(571) 346-1924
NPI assigned
Apr 7, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 0101259167 VA Primary

Addresses

Primary practice location

44055 Riverside Parkway, Suite 216
Leesburg, VA 20176

Mailing address

224-D Cornwall Street, NW, Suite 403
Leesburg, VA 20176-5176
Phone (703) 737-6010

Other identifiers 2

IdentifierTypeStateIssuer
1255656864MedicaidVA
30016466210001MedicaidVA

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
I20160517002071 VA Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain Management 9032408877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Interventional Pain Management
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Loudoun Medical Group, PCGroup PAC ID 0042119661, 272 clinicians

Practice addresses (Care Compare)

224 D Cornwall St NW
Suite 202
Leesburg, VA 20176-2700
Phone (703) 840-0665

Hospital & facility affiliations

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
0101259167VAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Group, PC Physical Medicine & Rehabilitation CurrentSince May 1, 2016 Accepting new patients
Loudoun Medical Group, PC CurrentSince May 1, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

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

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

224D Cornwall St NW
Ste 202
Leesburg, VA 20176
Phone (703) 443-8110

44055 Riverside Pkwy
Ste 216
Leesburg, VA 20176
Phone (703) 840-0665

44055 Riverside Pkwy
#20811302
Leesburg, VA 20176
Phone (703) 729-7652

Interoperability endpoints

  • Direct secure messaging: jon.mader@lmg1.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1255656864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224-D CORNWALL STREET, NW, SUITE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201765176",
            "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": "44055 RIVERSIDE PARKWAY, SUITE 216",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "20176",
            "telephone_number": "703-840-0665",
            "fax_number": "571-346-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADER",
        "first_name": "JON",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-07",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101259167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255656864",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30016466210001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.